手足口病後にunilateral acute idiopathic maculopathyを発症した1例

A case of unilateral acute idiopathic maculopathy following hand-foot-mouth disease

要約　目的：手足口病後にunilateral acute idiopathic maculopathy（UAIM）を発症した症例を報告する。

症例：13歳の女児が手足口病を発症した7日後に右眼の視力低下を自覚した。

所見：初診時の右眼の矯正視力は0.6であった。眼底検査では，右眼の黄斑部に顆粒状の色素脱失がみられた。フルオレセイン蛍光眼底造影では，黄斑部にリング状の過蛍光がみられた。光干渉断層計では，黄斑部に漿液性網膜剝離がみられ，ellipsoid zoneが不整であった。無治療で経過観察したところ，2か月後には視力は1.0に改善した。

結論：手足口病がUAIMの原因となりうることを知っておくことは重要である。

Abstract　Purpose: To report a case of unilateral acute idiopathic maculopathy following an episode of hand-foot mouth disease.

Case: A 13-year-old girl presented with impaired visual acuity in the right eye since 3 weeks before. She had had an episode of hand-foot-mouth disease that developed one week before impaired vision and that lasted for 5 days. Corrected visual acuity in the right eye was reportedly 0.6 four days after onset.

Findings and Clinical Course: Corrected visual acuity was 0.6 in the right eye and 1.2 in the left. The right eye showed granular depigmentation in the macula. The left eye was apparently normal. Fluorescein angiography showed a ring-shaped hyperfluorescence in the macular area. Spectral-domain optical coherence tomography showed serous retinal detachment and disrupted ellipsoid zone in the macula. Pathological findings in the right fundus disappeared spontaneously and visual acuity improved to 1.0 two months later.

Conclusion: This case illustrates that unilateral acute idiopathic maculopathy may develop after an episode of hand-foot-mouth disease.