両眼に発症したintrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhageの1例

A case of bilateral intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage

要約　目的：Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage（IHAPSH）は，視神経乳頭部の出血に加えて視神経乳頭の周囲に網膜下出血を生じる症候群である。出血は自然吸収し，視力予後は比較的良好とされているが，両眼発症の報告は少ない。今回，両眼にIHAPSHをきたした1例を報告する。

症例：36歳，女性。主訴は左眼の飛蚊症。

所見：初診時の眼底検査で左眼の乳頭腫脹，視神経乳頭部の出血，視神経乳頭の鼻側に網膜下出血を認めた。左眼には後部硝子体剝離があり，軽度の硝子体出血があった。初診より2か月後，自覚症状はなかったが，眼底検査で右眼の視神経乳頭部の出血，視神経乳頭の鼻側に網膜下出血を認めた。両眼の視神経乳頭部とその周囲の出血，左眼の乳頭腫脹と硝子体出血は徐々に吸収された。

結論：本症例は両眼に発症したIHAPSHと考えられ，既報と同様に視力予後は比較的良好であった。

Abstract　Purpose：Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage（IHAPSH）is a clinical syndrome with intrapapillary hemorrhage and peripapillary subretinal hemorrhage that usually resolves spontaneously with a relatively good visual outcome. There are few reports of bilateral IHAPSH in the literature. We report a case of bilateral IHAPSH.

Case：A 36-year-old woman presented with floaters in the left eye.

Findings：Fundus examination at the initial visit revealed disc edema, intrapapillary hemorrhage and nasal peripapillary subretinal hemorrhage in the left eye. She had a slight vitreous hemorrhage with posterior vitreous detachment in the left eye. Although she had no subjective symptoms of the right eye, fundus examination 2 months after the initial visit revealed intrapapillary hemorrhage and nasal peripapillary subretinal in the right eye. Intrapapillary hemorrhage and peripapillary subretinal hemorrhage in both eyes, and disc edema and vitreous hemorrhage in the left eye gradually resolved without treatment.

Conclusion：The present case was diagnosed with bilateral IHAPSH, with a relatively good visual outcome as previously reported.