脈絡膜剥離と浅前房を伴った頸動脈海綿静脈洞瘻の1例

A case of carotid cavernous sinus fistula manifesting shallow anterior chamber and choroidal detachment

　頸動脈海綿静脈洞瘻が30か月前に発症した68歳の女性が，同側の視野異常で受診した。患側に浅前房と脈絡膜剥離が発見された。インドシアニングリーン赤外螢光造影で，後極部から上方の中間周辺部に脈絡膜循環障害による低螢光斑と，後極部から鼻側にかけて脈絡膜静脈の拡大があった。このような所見は，海綿静脈洞瘻で好発するものであり，脈絡膜剥離に特異な変化であるとは考えにくい。赤外螢光造影で検出できない脈絡膜血管の透過性亢進が持続しているためと推定された。浅前房と脈絡膜剥離は1か月後に自然寛解した。

A 68-year-old female presented with visual field defect in her left eye. She had been suffering from carotid cavernous sinus fistula (CCF) since 30 months before. The affected eye showed shallow anterior chamber and choroidal detachment. Indocyanine green angiography showed hypofluorescent patches involving the posterior to the upper midperipheral fundus area, suggesting impaired choroidal circulation. The choroidal veins were dilated from the posterior to nasal fundus area. These angiographic features are common in CCF and, therefore, did not seem to be associated with choroidal detachment. Rather, they appeared to be due to persistent hyperperme-ability of choroidal vessels that cannot be detected by ICG angiography. The shallow anterior chamber and choroidal detachment resolved spontaneously one month later.