網膜・網膜色素上皮過誤腫の光干渉断層計所見

Combined hamartoma of the retina and retinal pigment epithelium observed by optical coherence tomography

要約　目的：網膜と網膜色素上皮過誤腫の3症例3眼をスペクトラルドメイン光干渉断層計（SD-OCT）で観察した所見の報告。

症例と所見：3症例はそれぞれ7歳女児，12歳男児，53歳女性である。過誤腫は乳頭部を含む眼底の後極部にあり，網膜血管の異常とともに網膜色素上皮（RPE）の脱色素と色素沈着が混在する境界不鮮明な病巣であった。矯正視力は3例とも1.0以上であった。フルオレセイン蛍光眼底造影では，腫瘍内の毛細血管が拡張増生し，インドシアニングリーン蛍光造影では，腫瘍部は低蛍光を呈した。SD-OCTでは，網膜全層の肥厚と層構造の消失，網膜外層の萎縮，RPEラインの肥厚，脈絡膜の菲薄化と反射亢進があった。

結論：網膜と網膜色素上皮過誤腫の診断にはSD-OCTが有用であり，脈絡膜の萎縮が生じていた。

Abstract　Purpose: To report 3 cases of combined hamartoma of the retina and retinal pigment epithelium as observed by spectral domain optical coherence tomography（SD-OCT）.

Cases and Findings: The present series comprised a 7-year-old girl, 12-year-old boy and 53-year-old female. All the cases were unilaterally affected. Corrected visual acuity was 1.0 or over in all the cases. The hamartoma was located in the posterior fundus or the disc area. It appeared as mixture of pigmentation and depigmentation of the retinal pigment epithelium（RPE）with capillary vessels within the hamartoma. The area of hamartoma showed hypofluorescence by indocyanine green angiography. SD-OCT showed thickening of the retina, disorganization of retinal layered structure, outer retinal atrophy, thickening of RPE line, and thinning of the choroid.

Conclusion: SD-OCT was useful in the diagnosis of combined hamartoma of the retina and retinal pigment epithelium. It showed atrophy of the choroid in the affected area.