朝顔症候群にみられた網膜剥離と眼底の不随意運動

Involuntary movement of the fundus in an eye of morning glory syndrome with retinal detachment

　14歳女子が右眼の視力低下を主訴として受診した。眼底に朝顔症候群と，下方に薄い非裂孔原性網膜剥離があった。パーフルオロカーボンを併用する硝子体手術により，網膜は復位した。全経過を通じて，乳頭を含む眼底の漏斗状陥凹部が前後方向に移動する現象が観察された。この運動は不随意であり，呼吸と脈拍とは関係がなく，光刺激と頸静脈の圧迫により誘発できなかった。この現象には，眼球後退筋または異所性の強膜内平滑筋の不随意収縮が関与していると推定された。

A 14-year-old girl presented with visual impairment in the right eye as chief compliant. Funduscopy showed morning glory syndrome with nonrhegmatogenous retinal detachment in the affected eye. The retina could be reattached by vitreous surgery and perfluorocarbon. During the whole course of observation, the excavated peripapillary fundus and the optic disc moved forward and backward. This movement was involuntary, since it was independent of respiration or pulsation and could not be induced by light stimulation or jugular compression. It appeared that this movement was caused by involuntary contraction of retractor bulbi muscle or heterotopic intrascleral smooth muscle.