開放隅角緑内障眼に合併した裂孔原性網膜剥離の術後視野変化

Changes in visual field following surgery for rhegmatogenous retinal detachment in an eye of open-angle glaucoma

（P1-2-23）　48歳男性が21か月前に両眼の緑内障と診断され，治療中であった。1週間前に左眼視力低下を自覚し，眼底の下半分に及ぶ網膜剥離が発見された。裂孔は下方赤道部にあった。陥凹／乳頭比は縦0.8，横0.7であり，上方に視野狭窄が検出された。眼圧は右20mmHg，左19mmHgであった。網膜剥離に対して手術を行い，復位を得た。術後の眼圧は21〜26mmHgを推移し，術後2週目の視野測定で当初はなかった求心性視野狭窄が発見された。輪部から20mm後方に置いた締結術がその主要原因であると推定されたが，緑内障による可能性も否定できない。緑内障の既往がある網膜剥離では，術後の視野狭窄の進行に留意すべきである。

A 48-year-old male had been diagnosed as bilateral glaucoma 21 months before. He noted visual failure in his left eye one week before, leading to detection of retinal detachment in the inferior equator. The cup/disc ratio was 0.8 vertically and 0.7 horizontally. The visual field showed constriction superiorly. The intraocular pressure (IOP) was 20 mmHg right and 19 mmHg left under medication. Surgery induced retinal reattachment. The IOP left ranged between 21 and 26 mmHg after surgery. At 2 weeks after surgery, visual field constriction, which was not present before, was detected. It seemed to be the consequence of deeply placed scleral encircling but could possibly due to glaucoma. This case illustrates the necessity to pay due attention to postoperative visual field deterioration in eyes with retinal detachment and glaucoma.