乳頭ピット黄斑症候群の術後黄斑円孔が長期経過で閉鎖した1例

Eventual closure of macular hole that developed after vitreous surgery for optic disc pit maculopathy

要約　目的：乳頭ピット黄斑症候群に対する硝子体手術後に生じた黄斑円孔が，長期経過で閉鎖した症例の報告。症例：58歳，女性。前医で左眼黄斑部網膜剝離と診断され紹介受診した。初診時視力は左（0.4）。光干渉断層像にて黄斑部網膜分離，網膜剝離，外層円孔を認めた。硝子体手術を施行し，乳頭ピット黄斑症候群と確定した。内境界膜剝離と20％六フッ化硫黄（SF₆）ガスタンポナーデを施行した。術後4か月で全層黄斑円孔（MH）となり，再度SF₆タンポナーデを行い，再手術後10か月で閉鎖が得られた。結論：ピット黄斑症候群に伴うMHは網膜下液の減少に伴い閉鎖が得られる可能性がある。

Abstract.　Purpose：To report a case of full-thickness macular hole that developed after vitreous surgery for optic disc maculopathy. Case：A 58-year-old female presented with serous macular detachment in the left eye. Corrected visual acuity was 1.5 right and 0.4 left. Both eyes were hyperoptic. The left eye showed retinoschisis, serous retinal detachment and outer macular hole by optical coherence tomography. A pit was present in the optic disc, Ieading to the diagnosis of pit-macular syndrome. The left eye was treated by vitrectomy, peeling of internal limiting membrane, and tamponade by sulfur hexafluoride. A full-thickness macular hole developed 4 months of surgery. The left eye received another session of tamponade by sulfur hexafluoride. The macular hole closed 10 months later. Conclusion：The present case illustrates that macular hole secondary to vitreous surgery for pit-macular syndrome may resolve belatedly after additional gas tamponade.