2年間に進行したクリスタリン網膜症の1例

A case of crystalline retinopathy with remarkable progression in two years

　2年後の再受診時に急激に進行していた42歳女性のクリスタリン網膜症の1例を報告する。初診時に角膜に結晶沈着物はなく，眼底後極部を中心に網膜色素上皮と脈絡膜毛細管板の萎縮とともに，黄白色閃輝性結晶様沈着物が左右対称性に散在していた。2年後の再受診時には，脈絡膜萎縮が著明になり，視力は両眼0.7から右眼手動弁，左眼0.1に，視野は輪状暗点から広範囲な中心暗点，ERGは低振幅から記録不能へと変化した。このような急激な進行例はこれまで報告がなく，本症の臨床経過を考える上で重要と思われる。

A 42-year-old woman was diagnosed as crystal-line retinopathy during check up for adult diseases. Funduscopy showed typical crystal-like spots and pigment clumps at the level of retinal pigment epithelium. The visual acuity was 0.7 in either eye. Perimetry showed normal peripheral visual fieldand ring scotoma in either eye. Single flash electroretinogram showed reduced amplitudes in a and b waves.

We reexamined her 26 months later. The visual acuity was 0.1 each. Remarkable concentric concen-tration was present in visual field of both eyes. Electroretinogram was non-recordable. The degen-eration of retinal pigment epithelium and atrophy of choriocapillaries were in more advanced state than during the initial examination. The crystal -like spots were essentially in a similar state in their size and density as 26 months before.