自然閉鎖を認めた黄斑円孔の4症例の検討

Review of four cases of spontaneous closure of macular hole

要約　目的：黄斑円孔が自然閉鎖した4症例の報告。

症例：症例1，2はそれぞれ54歳，55歳の女性で，左眼にstage 1B，stage 3の黄斑円孔を認めた。それぞれ1か月後，1か月半後には自然閉鎖した。症例3は46歳の男性。左眼に黄斑上膜および中心窩のやや耳下側にstage 3の黄斑円孔を認め4か月後には自然閉鎖した。症例4は53歳の男性。増殖糖尿病網膜症で硝子体手術を施行し，4年後に右眼に黄斑上膜に伴う黄斑円孔を認め3週間後には自然閉鎖した。

結論：Stage 3以上の特発性黄斑円孔や硝子体手術後の続発性の黄斑円孔においても自然閉鎖することがあり，後部硝子体剝離の完成や円孔部の架橋形成が自然閉鎖に関与する可能性が考えられた。

Abstract　Purpose: To report four cases of spontaneous closure of macular hole.

Case: Case 1, a 54-year-old female, had stage 1B macular hole, and case 2, a 55-year-old female, had stage 3 macular hole in the left eye, respectively. The macular hole closed spontaneously 1 month later in case 1, and one and a half months later in case 2. Case 3, a 46-year-old male, had epiretinal membrane and stage 3 macular hole in the left eye. The macular hole closed spontaneously 4 months later. Case 4, a 54-year-old male, had proliferative diabetic retinopathy, and underwent pars plana vitrectomy in both eyes. Epiretinal membrane was found in the left eye and macular hole developed 4 years after vitrectomy. The macular hole closed spontaneously 3 weeks later.

Conclusion: These result indicate that macular hole may resolve spontaneously following bridge formation and separation of vitreous membrane from the fovea.