出産後改善した増殖糖尿病網膜症の1例

A case of improved proliferative diabetic retinopathy after delivery

（P1-1-13）　糖尿病未治療の24歳妊婦に単純糖尿病網膜症がみられた。妊娠14週時に前増殖網膜症に進行し，さらに悪化傾向を示したため汎網膜光凝固を行った。その後さらに増殖網膜症に進行し視力低下をきたしたが，出産後，網膜症は軽快し増殖停止網膜症となって安定した。妊娠初期に血糖コントロール不良で網膜症をみた場合は，頻回の眼底精査により光凝固開始時期を見極めることが重要であり，増殖網膜症にまで進行しても出産後は改善しうることが示された。

A 24-year-old women had had non-insulin dependent diabetes mellitus without treatment since 5 years before. Simple diabetic retinopathy was detected at 10 weeks of pregnancy. Intense treatment of diabetes was started. At 14th week, the condition in both eyes progressed to preproliferative retinopathy. Despite panretinal photocoagulation, proliferative retinopathy developed with reduced vision. After uneventful delivery, the retinopathy showed remission to remain as arrested proliferative retinopathy. This case illustrates the necessity of close follow up with eventual panretinal photocoagulation when diabetic retinopathy is detected in the early stage of pregnancy. It also shows that proliferative retinopathy may undergo spontaneous remission after delivery.