網膜色素上皮裂孔を合併した胞状網膜剥離の1症例

A case of bullous retinal detachment with tear of retinal pigment epithelium

　49歳の男性が，左眼視野欠損を主訴として受診した。視力右1.0，左0.7で，両眼に多数の網膜色素上皮剥離があり，左眼の下方には胞状の網膜剥離がみられた。螢光眼底造影では左眼に多数の螢光漏出点と4.3×1.7乳頭径の網膜色素上皮裂孔が検出された。色素上皮裂孔部以外の螢光漏出点に対してクリプトンレーザー光凝固を2回施行したところ，網膜剥離は徐々に消失した。色素上皮裂孔部も瘢痕化し，左眼視力は0.4と比較的良好に維持できた。色素上皮裂孔を伴った胞状網膜剥離でも，裂孔部以外の漏出点への光凝固により剥離が消退し，裂孔部の瘢痕化が期待できるので，裂孔部以外の螢光漏出点に対する光凝固をまず試みるのがよいと考えた。

A 49-year-old male presented with visual field loss in his left eye. The visual acuiaty was 1.0 right and 0.7 left. Multifocal detachment of retinal pig-ment epithelium (RPE) was present in both eyes. Bullous retinal detachment was present in the left eye. Fluorescein angiography showed multiple points of dye leakage and a large tear in the RPE. Application of krypton laser photocoagulation to the sites of leakage excepting the tear in RPE resulted in reduction of retinal detachment and in scarring of the tear area. The visual acuity was maintained at 0.4 in the left eye. Laser photocoagulation to the sites of leakage alone seemed to be the treatment of choice for bullous retinal detachment with tear in the RPE.