鈍的眼外傷後の低眼圧黄斑症に伴った脈絡膜からの螢光漏出

Hypotony maculopathy associated with fluorescein leakage from the choroid following blunt ocular trauma

　自分の打った野球ボールが右眼に当たり，前房出血と約60^°の範囲に毛様体解離をきたした39歳男性に，低眼圧が持続した。受傷3か月後に黄斑耳側に限局性漿液性網膜剥離が発症し，螢光眼底造影で中心窩から3.5乳頭径の位置に下降性漏出点があった。アルゴンレーザー光凝固で剥離は消失した。低眼圧とこれに伴う黄斑症状は毛様体解離縫合術により治癒した。鈍的眼外傷後に多発性後極部網膜色素上皮症が発症した自験例との類似点などから，低眼圧の持続による外血液網膜柵の破綻が，本症例の網膜剥離の主因と考えられた。

A 39-year-old man was struck in the right eye by a flying object. When seen 4 days later, his visual acuity in the right eye was 0.2. Gonioscopy revealed a cyclodialysis cleft subtending 60 degrees infer-otemporally. Ocular hypotony was present. The visual acuity improved to 1.0 1 month later and decreased to 0.3 3 months after the trauma due to hypotony maculopathy with serous retinal detach-ment. Fluorescein angiography showed a point ofdye leakage from the choroid 3.5 disc diameters temporal to the macula. The dye diffusion showed a descending pattern. Argon laser photocoagulation was followed by disappearance of dye leakage and serous retinal detachment. We closed the cyclodialysis cleft by direct suture of the iris root to the scleral spur. This procedure resulted in dis-appearance of ocular hypotension and hypotony maculopathy. The visual acuity improved to 1.2. The observed dye leakage from the choroid was presumably secondary to persistent ocular hypotony.