妊娠中毒症に併発した漿液性網膜剥離に対する線溶療法

Fibrinolytic treatment for serous retinal detachment in toxemia of pregnancy

　漿液性網膜剥離の発生をみた37歳の晩期妊娠中毒症患者に螢光眼底造影を施行し，網膜下から多数の螢光色素漏出点を認めた。また，脈絡膜背景螢光充盈遅延を認め，脈絡膜循環障害の存在が示唆された。

　本来，妊娠中毒症に伴う漿液性網膜剥離は視力予後良好な疾患であるが，慢性DICの存在が推定されたため，ウロキナーゼ製剤による線溶療法を試み，網膜剥離のすみやかな消褪をみた。

A 37-year-old woman presented with serous retinal detachment in both eyes on the next day after delivery at 38 weeks of gestation. Fluorescein angiography showed multiple dye leakage through the retinal pigment epithelium in addition to chor-oidal filling delay. Laboratory findings were indica-tive of disseminated intravascular coagulation (DIC). We treated the patient with intravenous urokinase at 60,000 U per day. Prompt reattach-ment of the retina ensued in a few days.