周辺部網膜分離拡大予防目的で光凝固を施行した先天性網膜分離症の1例

A case of congenital retinoschisis treated by prophylactic photocoagulation

要約　目的：予防的光凝固を受けた先天性網膜分離症の1症例の長期経過の報告。症例：現在29歳の男性が，5歳時から当科を受診している。3歳時に両眼の先天性網膜分離症と診断された。母方の従兄弟も先天性網膜分離症と診断されている。5歳時の初診時の視力は，右0.03，左0.3で，両眼に車軸状の中心窩分離と周辺部網膜分離があった。左眼の周辺部網膜分離の後極寄りにアルゴンレーザーによる光凝固を行った。18歳時に前回の光凝固斑が網膜分離部内にあるように見え，さらに光凝固を追加した。11年後の現在まで，左眼の周辺部網膜分離の進展はない。結論：初回の光凝固では，周辺部網膜分離の進展を阻止できなかった。2回目の光凝固でも，瘢痕は網膜分離層には及んでいなかったが，周辺部の網膜分離の後極に向かっての拡大はなかった。

Abstract.　Purpose：To report a case of retinoschisis who was followed up for 24 years after prophylactic photocoagulation. Case：A boy has been seen by us from 5 until 29 years of age. He had been diagnosed with congenital retinoschisis at the age of 3 years. His cousin on the maternal side had also congenital retinoschisis. Visual acuity at the age of 5 years was 0.03 right and 0.3 left. Both eyes showed retinoschisis of the fovea and in the periphery. The left eye received laser photocoagulation along the posterior edge of peripheral retinoschisis. At the age of 18 years, coagulation scar appeared to be located within the area of retinoschisis, necessitating an additional photocoagulation. There has apparently been no progression of retinoschisis for 11 years until present. Conclusion：Photocoagulation at the age of 5 years failed to prevent progression of retinoschisis. There has been no progression of retinoschisis for 11 years after additional photocoagulation at the age of 18 years until present.