白内障手術翌日に後極部網膜剝離をきたした網膜色素上皮変性の1例

A case of pigment epithelium degeneration with posterior serous retinal detachment on the day after cataract surgery

要約　目的：白内障手術の翌日に網膜剝離が生じた症例の報告。症例：両眼の後極部に色素沈着がある79歳女性が，右眼に白内障手術を受けた。手術の翌日に後極部の網膜剝離が生じ，視力は術前の0.6が0.08に低下した。剝離の高さは約700μmで，感覚網膜は色素沈着域で色素上皮と癒着し，造影検査で同部に脈絡膜循環障害があった。経過観察のみで3か月後に視力は0.7に回復した。1年後に左眼の白内障手術を2か月間プロスタグランジン剤を投与した後に行い，術中術後に問題はなかった。結論：眼底に色素沈着がある症例には，脈絡膜循環と網膜色素上皮機能の障害を伴っている可能性があり，白内障手術を行う際には，術前に造影検査を用いた評価をすることが勧められる。

Abstract.　Purpose：To report a case developed posterior serous retinal detachment on the day after cataract surgery. Case：A 79-year-old female presented with cataract and pigmented retina at posterior pole of her both eyes. She received cataract surgery in the right eye. Posterior serous retinal detachment developed on the day after cataract surgery. Visual acuity decreased from 0.6 to 0.08. The sensory retina was adhered to the retinal pigment epithelium at the pigmented area. Angiography showed impaired choroidal circulation in the pigmented area. Visual acuity improved to 0.7 three months later without treatment. Cataract surgery was performed on the left eye one year later after systemic administration of prostaglandin for 2 months. There was no problem during and after surgery. Conclusion：Eyes with retinal pigmentation may be associated with choroidal vascular disorder and impaired function of retinal pigment epithelium. Assessment of fundus angiography is recommended to such eyes before cataract surgery.