裂孔原性網膜剝離に対する硝子体手術後に特徴的な白斑を認めた1例

A case of white retinal patches after vitreous surgery for rhegmatogenous retinal detachment

要約　目的：裂孔原性網膜剝離に対する硝子体手術後に特徴的な白斑を認めた症例を報告する。症例：45歳，男性。右眼裂孔原性網膜剝離の診断で当科を紹介受診した。所見：右眼矯正視力は0.02で眼底の上耳側に裂孔があり，黄斑を含む網膜剝離を認めた。右眼の硝子体手術を施行し速やかに網膜は復位した。術後2週目に以前の剝離境界部の剝離網膜側に沿って眼底自発蛍光で過蛍光となる円形の白斑を認めた。白斑部の自発蛍光は術後4週目で最も過蛍光になり，術後12週目で自然に消失した。結論：部分的に円形に残存した剝離網膜下に視細胞外節由来物質が蓄積し，自発蛍光にて過蛍光となる白斑を形成したと推測した。

Abstract.　Purpose：To report a case of white retinal patches after vitreous surgery for rhegmatogenous retinal detachment. Case：A 45-year-old male was referred to us for rhegmatogenous retinal detachment in the right eye. Findings：Corrected visual acuity was 0.02 in the affected eye. A retinal break was present in the superior temporal periphery, with retinal detachment extending to the macula. The right eye received vitreous surgery, evacuation of subretinal fluid through the retinal break, and vitreous-air exchange followed by injection of sulfur fluoride. The retina became reattached the following day. When seen 2 weeks after surgery, numerous white patches were located along the previous border of retinal detachment. The patches showed intense autofluorescence. The spontaneously resolved 12 weeks after surgery. Conclusion：The white patches seen in the present case may have derived from material originating from outer segments of photoreceptors in the residual subretinal fluid.