妊娠中に発症し出産後に自然退縮した特発性脈絡膜新生血管の1例

A case of idiopathic choroidal neovascularization with onset during pregnancy and regression after delivery

要約　目的：妊娠中に発症し，出産後に自然退縮した特発性脈絡膜新生血管（ICNV）の1例を報告した。

症例：35歳，女性。妊娠23週頃に左眼の歪視，視力低下を自覚し，ICNVと診断された。矯正視力は0.4で中程度の近視を認めた。妊娠中であったため，ステロイドのテノン囊下注射や抗血管内皮増殖因子薬の硝子体注射などの積極的な治療を希望されず，経過観察を行った。出産後にICNVは徐々に退縮し，矯正視力は0.9に改善した。

結論：ICNV退縮の原因として，妊娠による循環変化，あるいはホルモンの影響などが推測された。

Abstract　Purpose: To report a case of idiopathic choroidal neovascularization that set in during pregnancy and regressed after delivery.

Case: A 35-year-old woman was referred to us for metamorphopsia in the left eye since 3 weeks before. She was in the 26th week of pregnancy.

Findings and Clinical Course: Corrected visual acuity was 1.2 right and 0.4 left. Both eyes were myopic at about −5 diopters. The left eye showed findings suggestive of idiopathic choroidal neovascularization. Aggressive treatment was withheld because of pregnancy. Fundus findings improved with visual acuity of 0.8 when seen one month after uneventful delivery. She has been doing well for 3 years until present.

Conclusion: Idiopathic choroidal neovascularization in the present case appears to be etiologically associated with pregnancy through hormonal or circulatory changes.