Unilateral acute idiopathic maculopathyの1例

A case of unilateral acute idiopathic maculopathy

要約　背景：片側性急性特発性黄斑症（unilateral acute idiopathic maculopathy：UAIM）は，感冒様の症状に続き，健常な成人の片眼に急激な視力低下が生じ，黄斑部に黄白色の滲出斑が現れる疾患である。目的：UAIMと推定される1症例の報告。症例：38歳男性が左眼の急激な視力低下で紹介受診した。感冒様の症状はなかった。視力は右1.5，左0.15で，左眼の中心窩下に1.5乳頭径大の黄白色の病巣があった。光干渉断層計で網膜色素上皮の不整とIS/OS線の消失があった。フルオレセイン蛍光眼底造影で，早期では不均一な過蛍光，後期には組織染があった。UAIMと診断した。視力は1か月後に0.5，2か月後に0.9，4か月後に1.2に自然寛解した。結論：急激な黄斑部の黄白色の滲出斑を呈する病変では，感冒様症状が先行しなくても，UAIMである可能性がある。

Abstract.　Background：Unilateral acute idiopathic maculopathy（UAIM）is characterized by symptoms of common cold followed by impaired visual acuity with yellowish exudative spots in the macula in healthy adults. Purpose：To report a presumed case of UAIM. Case：A 38-year-old male presented with acutely impaired vision in the left eye. He was free of symptoms suggesting common cold. Findings：Corrected visual acuity was 1.5 right and 0.15 left. The left eye showed yellowish circumscribed lesion of 1.5 disc diameters across. Optical coherence tomography showed irregular retinal pigment epithelium and absence of IS/OS line. Fluorescein angiography showed irregular hyperfluorescence in the early phase and tissue staining in the late phase. The findings led to the diagnosis of UAIM. Visual acuity in the affected eye recovered spontaneously to 0.5 one month later, 0.9 two months later, and to 1.2 four months later. Conclusion：This case illustrates that yellowish exudative spots in the macula may be manifestations of UAIM even in the absence of symptoms of common cold.