正常妊娠中に発症した中心性漿液性脈絡網膜症の1例

A case of central serous chorioretinopathy during normal pregnancy

要約　目的：正常妊娠中に発症した中心性漿液性脈絡網膜症の1例の報告。

症例：35歳，女性が第2子の妊娠25週に右眼視力低下を自覚し，その翌週に当科を受診した。

所見と経過：矯正視力は右0.7，左1.5で，右眼黄斑部に漿液性網膜剝離があり，光干渉断層計でこの所見が確認された。産婦人科で妊娠高血圧症候群は否定された。妊娠中なので，蛍光眼底造影などの侵襲性のある検査は控えた。妊娠36週で右眼の自覚症状は改善し，漿液性網膜剝離は消失して矯正視力は0.9になった。妊娠37週6日に帝王切開で正常な男児を出産した。出産1か月後，漿液性網膜剝離の再発はなく，右眼の矯正視力は1.0に回復した。

結論：正常妊娠中に中心性漿液性脈絡網膜症と思われる黄斑症が発症し，妊娠後期に自然寛解した。

Abstract　Purpose：To report a case who developed central serous chorioretinopathy during normal pregnancy.

Case：A 35-year-old woman noted impaired vision in the right eye during 25 weeks of normal second pregnancy. She was seen by us one week later.

Findings and Clinical Course：Best corrected visual acuity was 0.7 right and 1.5 left. The right eye showed serous retinal detachment in the macula. Optical coherence tomography confirmed this finding. Gynecological examinations denied the possibility of pregnancy hypertensive syndrome. She was followed up without further examinations or medications. Subjective findings spontaneously improved at 36th of gestation. Serous macular detachment disappeared and visual acuity improved to 0.9. She gave birth to a normal baby by caesarean section at 37 week and 6 days of pregnancy. There has been no recurrence of macular detachment for month.

Conclusion：Unilateral fundus lesion compatible with the diagnosis of central serous chorioretinopathy developed during pregnancy and spontaneously resolved before birth of a normal child.