Uveal effusion syndromeに対するsclerectomy-sclerostomyの効果

Effects of sclerectomy-sclerostomy for uveal effusion syndrome

　Uveal effusion syndromeが強く疑われる2症例（43歳と62歳のいずれも男性）を経験した．共に非裂孔原性で下液が容易に移動する胞状の網膜剥離を有し，髄液検査で細胞増多を伴わない蛋白の上昇を示した．

　症例　1にはステロイド療法を，症例2には網膜下液排出術と全周締結術を施行したが，いずれも増悪を来したため，sclerectomy-sclerostomy（Gass）の手術を施行した．術後，網膜下液は着実に減少し，3〜4カ月後には完全に消失した．本症の特徴の一つとして自然治癒傾向が指摘されており，手術成績の評価に検討の余地はあるが，今回の症例の経験より，sclerectomy-sclerostomyは本症に着実な効果の得られる治療法であると考えられた．

We treated uveal effusion in 2 males aged 43 and 62 years. The condition was unilateral in both cases. They presented with non-rhegmatogenous bullous retinal detachment with shifting subretinal fluid. The cerebrospinal fluid showed elevation of protein without pleocytosis. Initially, the first case was treated with systemic steroid and the second was operated by scleral encircling with subretinal fluiddrainage. These procedures were futile and the retinal detachment progressed further.

We then operated the two cases by performing partial-thickness sclerectomy and sclerostomy in each of the four quadrants after the method by Gass in 1983.

The exudative retinal detachment absorbed com-pletely 3 to 4 months after surgery. The sclerectomy -sclerostomy seems to be indicated for uveal effu-sion syndrome, particularly in cases with proctract-ed clinical course and tendency to exacerbation.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(6) : 640-643, 1987