網膜色素変性に伴う囊胞様黄斑浮腫に炭酸脱水酵素阻害薬の点眼加療が有効と思われた1例

Instillation of carbonic anhydrase inhibitor was apparently effective for cystoid macular edema in a patient of retinitis pigmentosa

要約　目的：網膜色素変性患者に生じた囊胞様黄斑浮腫に対し，炭酸脱水酵素阻害薬の点眼が有効と思われた症例の報告。症例：63歳女性が左眼の霧視で受診した。2年前に前医で原因不明の左眼の黄斑浮腫，両眼の緑内障と診断され，21か月前に左眼に白内障手術，硝子体手術，ステロイドのテノン囊下注射を受けた。所見：矯正視力は右0.5，左0.2で，眼圧は右12mmHg，左7mmHgであった。左眼に囊胞様黄斑浮腫があり，両眼の網膜電図が平坦で，網膜色素変性と診断した。左眼に1％ブリンゾラミドの点眼を1日2回行った。光干渉断層計による観察で，囊胞様黄斑浮腫は点眼開始から7か月半後の現在までに改善し，視力は0.3になった。結論：硝子体手術，ステロイドのテノン囊下注射を施行後も遷延した囊胞様黄斑浮腫に対し，炭酸脱水酵素阻害薬の点眼が有効と思われた。

Abstract.　Purpose：To report the apparently beneficial effect of instillation of carbonic anhydrase inhibitor for cystoid macular edema（CME）in a patient of retinitis pigmentosa. Case：A 63-year-old female presented with blurring in the left eye. She had been diagnosed with CME in the left eye and glaucoma in both eyes 2 years before. She had received cataract surgery, vitrectomy and subtenon injection of corticosteroid 21 months before. Findings：Corrected visual acuity was 0.5 right and 0.2 left. Intraocular pressure was 12 mmHg right and 7 mmHg left. The left eye showed CME. Electroretinogram was flattened in both eyes, leading to the diagnosis of retinitis pigmentosa. The left eye started instillation of 1％ brinzolamide twice daily. Optical coherence tomograph showed improved CME 7 months and a half later with visual acuity of 0.3. Conclusion：Instillation of carbonic anhydrase inhibitor was apparently effective for CME in a patient of retinitis pigmentosa.