網膜芽細胞腫に対する放射線療法，冷凍凝固後に発症した裂孔原性網膜剥離

Rhegmatogenous retinal detachment in an eye of retinoblastoma treated by radiation and cryocoagulation

　網膜芽細胞腫に対する放射線療法，冷凍凝固後に裂孔原性網膜剥離を合併した1例を報告した。症例は女児，生後4か月で両眼の網膜芽細胞腫と診断され，左眼には眼球摘出術，右眼には放射線療法を行った。その後，腫瘍が再発して温熱化学療法，冷凍凝固，光凝固を繰り返した。2歳9か月時に，併発した白内障に対し水晶体吸引術を行ったところ，網膜全剥離がみられた。硝子体手術を行い，後部硝子体剥離と石灰化した腫瘍周囲の硝子体網膜癒着を伴う凝固瘢痕部内に裂孔を発見した。網膜は復位し，再発もみられていない。網膜芽細胞腫の放射線療法や局所療法後には，裂孔原性網膜剥離の合併にも注意を払う必要があると考えられた。

A 4-month-old female infant was diagnosed as bilateral retinoblastoma. The left eye was treated by enucleation and the right by radiation. The right eye received repeated thermochemotherapy, cryocoagulation and photocoagulation for recurrence. Total retinal detachment was detected after surgery for complicated cataract at the age of 2 years 9 months. Vitreous surgery led to the detection of posterior vitreous detachment and retinal breaks in the coagulated scar areas with vitreoretinal adhesion around the calcified tumor. During the following one year, the retina has been attached with no reccurrence of the tumor. This case illustrates that rhegmatogenous retinal detachment is a possibility in retinoblastoma treated by radiation or retinal coagulations.