両眼の乳頭上に発生した網膜細動脈瘤の1例

Bilateral prepapillary macroaneurysm. Report of a case

　両眼の乳頭上に多発した網膜細動脈瘤を，6年間にわたって経過観察した。症例は51歳の女性で，主訴は左眼に急発した視力障害であった。左眼の上耳側動脈枝に1個，乳頭面上に2個の網膜細動脈瘤が認められ，矯正視力は0.01であった。網膜出血と黄斑部浮腫は次第に消退し，上耳側動脈の細動脈瘤は器質化して7ヵ月後には視力は1.0まで改善した。2個の乳頭面上の細動脈瘤もやや発赤拡大した後，4年6ヵ月後に器質化した。初診時右眼にも，4分の1乳頭径で黄色円形の細動脈瘤が3個乳頭上に認められた。中央の1個は，発赤して1乳頭径まで拡大し，4年3ヵ月後には網膜中心動脈枝閉塞症を併発したが，4年6ヵ月後に黄白色となり器質化してきた。

A 51-year-old female presented with central scotoma in her left eye. She had been suffering from poorly controlled systemic hypertension over the foregoing 20 years.

We detected the presence of macular edema and arterial macroaneurysm of one-half disc diameter (DD) along the superior temporal artery in her left eye. We observed, additionally, the presence of macroaneurysm 1/3 DD on the optic disc in the left eye and three macroaneurysm of 1/4 DD on theoptic disc in the right eye. Spontaneous resolution of retinal hemorrhage and macular edema resulted 7 months later in the left eye with improvement in vision.

Four years and 6 months later, the prepapillary macroaneurysms increased in size to 1 DD in both eyes. They then later changed the color to gradu-ally become yellowish-white. Branch retinal artery occlusion developed in the right eye later. These changes seemed to reflect spontaneous regression of the macroaneurysm.