自然閉鎖した特発性黄斑円孔患者の視機能と日常生活での物の見え方

Subjective and objective visual perception in a patient before and after spontaneous closure of idiopathic macular hole

要約　目的：自然閉鎖した特発性黄斑円孔（MH）患者の視機能と，日常生活の物の見え方を経時的に追跡した報告。

症例：71歳，女性。1か月前からの左視力低下と変視を主訴に来院。初診時矯正視力は0.15，高度の変視を呈し，MHを認めた。患者は日常生活に支障をきたしている訴えとともに，その絵を書いてきた。しかし3か月後にMHは自然閉鎖した。閉鎖後6か月の間に視力は0.4に改善，変視や不等像視，コントラスト感度，立体視もそれぞれ改善していた。

結論：MHが自然閉鎖し，視機能は改善，自覚症状はほぼ消失し，患者のquality of lifeは改善した。閉鎖前後で患者の実際の見え方を絵として残しており，貴重な症例であると考えられた。

Abstract　Purpose: To report longitudinal changes in subjective and objective visual perception in a patient before and after spontaneous closure of idiopathic macular hole.

Case: A 71-year-old woman presented with impaired vision and metamorphopsia in her left eye since one month before.

Findings and Clinical Course: Best-corrected visual acuity was 0.8 in the right eye and 0.15 in the left. Funduscopy and optical coherence tomography showed stage 3 macular hole in the left eye. She complained of disturbed daily life due to metamorphopsia, and drew pictures of clock, escalator and bus as they appeared to her. The macular hole closed spontaneously 3 months later. Visual acuity in the left eye improved to 0.4, along with improvement in metamorphopsia, aniseikonia, contrast sensitivity, and stereoacuity. She reported improved quality of life.

Conclusion: Spontaneous closure of macular hole was followed by improvement in visual acuity as well as various visual functions and quality of life.