巨大な網膜色素上皮裂孔による網膜剥離とその治療の1例

A case of retinal detachment with giant tear in the retinal pigment epithelium

　43歳の女性の右眼眼底に，下方に胞状の網膜剥離と全周に軽度の脈絡膜剥離がみられ，鼻下側赤道部に約1象限にわたる網膜色素上皮剥離があり，その後極側の辺縁に沿って細長い色素上皮裂孔がみられた。その後，色素上皮裂孔は1象限の大きさに拡大し，網膜剥離の増強をみた。眼軸長20mmの真性小眼球（nanophthalmos）があった。

　Uveal effusion　の治療に準じた強膜半層切除術および強膜開窓術を行った。網膜剥離は消失し，色素上皮裂孔は色素沈着を伴って瘢痕化して治癒した。

　網膜剥離を伴った大きい網膜色素上皮裂孔の治療例を報告した。

A 43-year-old female presented with bullous retinal detachment in the inferior hemisphere in her right eye. A large detachment with tear of retinal pigment epithelium was located in the inferior nasal quadrant of the affected eye. Fluorescein angiography showed massive dye leakage through the tear in the pigment epithelium into the sub-retinal space. The tear became larger 2 weeks later. The retina became totally detached. Both eyes were nanophthalmic with the axial length of 20 mm. We performed lamellar scleral resection along the inferior half of equator with drainage of sub-retinal fluid. The retina became reattached 10 days after surgery. There has been no recurrence during the ensuing 18 months.