長期間経過観察しえた鎌状赤血球網膜症の1例

Longterm clinical course of a case of sickle cell retinopathy

　27歳のガーナ人男性が左眼の飛蚊症で受診した。視力は両眼とも正常であったが，両眼の周辺部全周に無血管帯があり，硝子体腔に突にする新生血管が，いわゆる海草sea fanの形で存在した。末梢血の塗抹標本で鎌状赤血球があり，電気泳動で異常ヘモグロビンが分離された。右眼を第3期，左眼を第4期の増殖鎌状赤血球網膜症と診断した。両眼の周辺部無血管帯と新生血管周囲に光凝固を行い，8か月後に新生血管は消失した。以後9年間，新生血管の再発はなく，良好な視力を維持している。

A 27-year-old Ghanaian male presented with seeing floaters in his left eye. The visual acuity was normal in both eyes. Funduscopy showed avascular zone in the whole periphery in both eyes. New vessels were present simulating sea fans. Sickle cells and abnormal hemoglobin were detected in the circulating blood. He was diagnosed as proliferative sickle cell retinopathy. Photocoagulation to the avascular zone induced regression of neovascularization 8 months later. He has been maintaining full visual acuity without recurrence of neovascularization during the ensuing follow up for 9 years.