巨大裂孔に黄斑裂孔を伴った両眼性網膜剥離の1例

A case of bilateral retinal detachment with giant retinal tear and macular break

　26歳女性が両眼性網膜剥離のため受診した。精神分裂病のため詳細な問診は不可能であったが，夫から殴られた既往歴があった。視力，右眼0.01（n．C.），左眼指数弁（n．c．）。眼圧，右眼8mmHg，左眼30mmHg。両眼に虹彩炎があり，隅角後退が疑われた。水晶体混濁，硝子体混濁がみられた。右眼眼底には耳側180°の，左眼には270°の巨大裂孔がみられ，裂孔縁は翻転していた。両眼とも水晶体切除，硝子体切除を行い，翻転裂孔縁を元に戻すと黄斑裂孔が発見された。右眼は液—空気置換により，左眼はperfluorodecalinにより網膜を復位させ，シリコンオイルタンポナーデを行った。術後視力は右眼0.8，左眼0.1と改善した。

A 26-year-old woman presented with bilateral retinal detachment. She had been beaten several times by her husband. Visual acuity was 0.01 in the right eye and counting fingers in the left. Intraocular pressure was 8 mmHg right and 30 mmHg left. Iritis, cataract, angle recession and vitreous opacity were present. Funduscopy showedbilateral retinal detachment with giant tear, rang-ing 180 degrees in the right eye and 270 degrees in the left. The detached retina was inverted in both eyes. Macular breaks were detected after len-sectomy and vitrectomy in both eyes. The retina was reattached with fluid-air exchange in the right eye and with perfluorodecalin in the left with addi-tional silicone tamponade in both eyes. Visual acuity improved to 0.8 and 0.1 respectively.