一過性網膜虚血に伴った傍中心窩急性中間層黄斑症の1例

Paracentral acute middle maculopathy in a case of transient retinal ischemia

要約　目的：傍中心窩急性中間層黄斑症（PAMM）は，深層網膜毛細血管の虚血性病変で，光干渉断層計（OCT）での内顆粒層の帯状の高反射像が特徴的である。網膜中心動脈閉塞症による一過性網膜虚血に伴ったPAMMの1例を報告する。

症例：53歳，男性。未治療の高血圧。右眼の視力低下を自覚。翌日視力1.5。OCTで内顆粒層の帯状高反射部がみられた。フルオレセイン蛍光造影では網膜血流は正常で，OCT血管造影（OCTA）でも表層および深層の網膜毛細血管血流は保たれていた。1か月後，明らかな内顆粒層萎縮はみられなかった。

結論：虚血の程度の軽いPAMMを経験した。PAMMの診断，虚血の程度の評価にOCT，OCTAは有用である。

Abstract　Purpose：To report a case of transient retinal ischemia secondary to central retinal artery manifesting paracentral acute middle maculopathy（PAMM）when studied by optical coherence tomography（OCT）and OCT angiography.

Case：A 53-year-old male presented with sudden blurring in the right eye the previous day. His vision had recovered to 1.5 when seen by us. Fluorescein angiography showed normal filling in the early phase. OCT showed enhanced reflection in the inner nuclear layer and retinal ganglion layer arranged concentrically temporal to the fovea. The finding was interpreted as PAMM. OCT angiography showed normal retinal vascular network including superficial and deep capillary plexus. When seen one month later, the initially observed hyperreflection was absent with no atrophic findings in the inner nuclear layer.

Conclusion：The present case of PAMM showed minor ischemic lesions in the retina. OCT and OCT angiography were useful in the diagnosis and evaluation of PAMM.