実験用Nd：YAGレーザー誤照射による黄斑外傷のoptical coherence tomography像

Optical coherence tomographic features in a case of maculopathy following accidental Nd:YAG laser

　25歳男性がヤグレーザー（Nd：YAG laser）による黄斑外傷で受診した。患者は工学部大学院生で，実験中にプリズムによるレーザーの反射光が左眼に飛入し，その直後から視力低下と中心暗点を自覚した。レーザーは，波長1,064nm，出力80mJ／pulse，パルス幅10nsであった。左眼は-6.0Dの近視で、受傷当日の矯正視力は0.3であった。受傷眼に軽度の硝子体出血と黄斑浮腫があった。副腎皮質ステロイド薬を経口投与し，矯正視力は1週後0.6,2週後0.9、9か月後1.5に回復した。受傷9か月後に光干渉断層検査（OCT）を行い，中心小窩のやや上方に明瞭な縁のある網膜色素上皮欠損と，中心窩周囲に網膜前膜が観察された。工業用のヤグレーザーによる眼誤照射が危険であり，安全対策が必要であることを示す症例である。

A 25-year-old male presented with maculopathy by Nd: YAG laser irradiation. The patient was a graduate student of technology. During an experiment, his left eye received laser emission reflected by a prism. He noted reduced visual acuity and central scotoma immediately after the accident. The causative la-ser was a pulsed one with 1,064 nm in wavelength, 80 mJ/pulse in output, and 10 ns in duration. When seen the same day, his visual acuity was 0.3 corrected by -6.0D in the left eye. The affected eye showed mild vit-reous hemorrhage and macular edema. He was treated by peroral corticosteroid. The corrected visual acuity improved to 0.6 one week later, 0.9 two weeks later and 1.5 9 months later. Optical coherence tomography (OCT) 9 months after the accident showed a sharply demarcated defect of retinal pigment epithelium supe-rior to the foveola surrounded by epiretinal membrane. This case illustrates the necessity to avoid accidental eye injury by industrial laser.