Rathke囊胞を合併した漿液性網膜剝離の3例

Three cases of Rathke's cleft cyst with serous retinal detachment

要約　目的：Rathke囊胞に漿液性網膜剝離が併発した3症例の報告。

症例：症例1は15歳男児で，4年前から片頭痛・両眼の乳頭浮腫・右眼の漿液性網膜剝離があったという。Rathke囊胞が発見され，その摘出手術で視力と眼底所見が正常化し再発は認めない。症例2は24歳女性で，8年前から片頭痛があり，6年前にぶどう膜炎の所見を伴わない漿液性網膜剝離があり，原田病疑いで加療し改善した。同様の所見が今回再発し，Rathke囊胞が発見された。摘出手術後再発は認めない。HLA型はDR14，DR15であった。症例3は39歳女性で，9年前から片頭痛があり，両眼の視力低下で受診した。ぶどう膜炎の所見を伴わない両眼の漿液性網膜剝離があり，原田病の疑いで加療し改善した。その6か月後に両眼の漿液性網膜剝離が再発し，Rathke囊胞が発見された。摘出手術後，漿液性網膜剝離は完治したが5か月後に漿液性網膜剝離が再発した。

結論：これら3症例では，Rathke囊胞と漿液性網膜剝離との間に因果関係が存在する可能性が示唆された。

Abstract　Purpose: To report 4 eyes of 3 cases who showed Rathke's cleft cyst and who developed serous retinal detachment.

Cases: One was a 15-year-old boy. He had reportedly migraine, papilledema, and serous retinal detachment in the right eye since 4 years before. Rathke's cleft cyst was detected. Resection of the cyst was fol-lowed by improved visual acuity and fundus findings. The other was a 24-year-old female. She had had hemicrania since 8 years. She showed HLA of DR14 and DR15. The third case was a 39-year-old female who had had migraine and who complained of recently impaired visual acuity in both eyes. She showed serous retinal detachment without signs of uveitis. Therapy under the tentative diagnosis of Harada disease was followed by disappearance of retinal detachment. Similar fundus lesion developed in both eyes 6 months later. Rathke's cleft cyst was detected. Resection of the cyst was followed by improvement in visual acuity and fundus findings. Retinal detachment recurred 5 months later.

Conclusion: Presence of Rathke's cleft cyst may have been involved in the pathogenesis of serous retinal detachment.