硝子体出血を発症した網膜色素変性症を疑った1例

A case of vitreous hemorrhage with atypical retinitis pigmentosa

（P1-2-2）　75歳，男性の片眼に硝子体出血が発症し，超音波検査で腫瘍状陰影が指摘された。硝子体手術を行った結果，腫瘍状陰影は多量の脈絡膜血腫であることがわかり，血腫の周辺部に残存網膜を認めた。血腫除去後周辺部を冷凍凝固し，ガス注入して手術を終えた。術後高眼圧が持続し，視野狭窄ならびに視力低下をきたした。最終矯正視力は0.1であった。網膜が裂けたにもかかわらず網膜剥離をきたさなかったのは，網膜色素変性症様の網脈絡膜の萎縮病変のためと思われた。硝子体出血を伴った原因として，新生血管と無血管帯の関与が考えられた。

A 75-year-old male presented with vitreous hemorrhage in his right eye. Ultrasonography showed a tumorous shadow. A massive choroidal hematoma was detected during vitreous surgery. The tumor was removed, the surrounding retina was cryocoagulated and the vitreous was replaced by SF6. Following temporary ocular hypertension, visual constric-tion developed with the final visual acuity of 0.1. The absence of retinal detachment despite retinal breaks due to choroidal hematoma appeared to be retinochoroidal atrophy simulating retinitis pigmentosa. Vitreous hemorrhage was presumably secondary to capillary nonperfusion and neovascularization.