螢光眼底造影でとらえた網膜細動脈を流れる栓子

Documentation of moving emboli by fluorescein angiography

　網膜細動脈を流れる栓子を撮影する機会があり報告した。症例は高血圧，狭心症を有する66歳の男性で，左眼の視野欠損を自覚した翌日，当院を初診した。初診時，網膜動脈分枝部に白色栓子を認め，これによる閉塞症と考え，眼底撮影と螢光眼底造影を施行した。施行中，突然，栓子の破片と考えられる移動性栓子が現れ，追跡撮影した。白色栓子の壊れ易い性質，移動性栓子の所見，患者の循環器系の検索から白色栓子は動脈硬化病巣に由来するフィブリン・血小板栓子と考えられた。

A 66-year-old male presented with sudden impairment in visual field in his left eye since 24 hours before. We observed, by funduscopy, a white embolus located in the superior temporal retinal artery in the affected eye, compatible with the diagnosis of branch retinal artery occlusion.

During the procedure of fundus photography and fluorescein fundus angiography, we observed sud-den appearance of small moving emboli peripheral to the white embolus. They appeared to be fra-grents of the white embolus. They moved slowly towards the peripheral retina. They appeared as moving bands on fluorescein angiogram as they were preceded by a bolus of the dye. Their color and fragility suggested that the emboli were com-posed of fibrin-platelet clumps.