両眼に網膜色素上皮裂孔を伴った多発性後極部網膜色素上皮症の1例

A case of bilateral multifocal posterior pigment epitheliopathy associated with retinal pigment epithelial tears

　ネフローゼ症候群に対しプレドニゾロンの全身投与を受けている67歳男性の両眼に，急激な視力低下が生じた。両眼に滲出性網膜剥離，多発性網膜色素上皮裂孔があり，蛍光眼底造影で蛍光色素の漏出と貯留，網膜色素上皮裂孔に一致した過蛍光があった。多発性網膜色素上皮症multiple posteriorpigment epitheliopathy （MPPE）と診断した。蛍光色素の漏出点と網膜色素上皮裂孔に対してレーザー光凝固を行い，網膜下液の吸収と消失，蛍光色素漏出の停止が得られた。自然寛解の傾向がない本症に対して光凝固術が有効であることを示す症例である。

A 67-year-old male presented with acute visual loss in both eyes of one week's duration. He had been under treatment with systemic prednisolone for nephrosis syndrome. Both eyes showed exudative retinal betachment and multiple tears in the retinal pigment epithelium (RPE). Fluorescein angiography showed leakage and pooling of dye with hyperflorescence in the area of tear in the RPE. The fundings led to the diagnosis of multifocal posterior pigment epitheliopathy (MPPE). Laser photocoagulation was applied to areas of bye leakage and to the RPE tear, resulting in resolution of subretinal fluid and cessation of bye leakage. This case illustrates the usefuleness of laser photocoagulation for persistent MPPE with tear in the RPE.