脈絡膜骨腫の蛍光眼底所見

Fluorescein angiographic findings of choroidal osteomas

　長期観察例を含めた脈絡膜骨腫5例6眼について蛍光眼底所見を中心に検討した。眼底所見にはさまざまな時期の病変が混在し，橙赤色部，黄白色部，綱膜脈絡膜萎縮部の3つに大別できた。蛍光眼底所見として，橙赤色部及び黄白色部ではwindow defectとそれに引き続くstainingが，網膜脈絡膜萎縮部では萎縮に一致する低蛍光が特徴であった。造影初期の脈絡膜相から出現する微細な過蛍光は，腫瘍の黄白色部に認められ，これはvascular tuftsの造影所見と考えられた。また，病変の近傍に検眼鏡上異常がみられなくとも微弱な過蛍光を示す部位があり，蛍光眼底造影によってのみ初期の病変が見出されることがあることも示唆された。長期観察例の所見より，各病変における蛍光眼底所見は，脈絡膜骨腫の予後についての判断の一助となると思われた。

We evaluated the fluorescein angiographic fea-tures in 6 eyes of 5 cases with choroidal osteoma. The diagnosis was confirmed by ultrasonography, computed tomography and x-ray of the skull. There were 3 types of the lesion when seen by ophthalmoscopy : orange-red, yellowish-white and chorioretinal atrophic areas. Two eyes were foll-owed up for 4 and 14 years respectively. The ini-tially orange-red lesion turned into yellowish -white and then to chorioretinal atrophy.

By fluorescein angiography, the orange-red and yellowish-white lesions showed window defect andtissue stainig from the early filling phase on.Hyper-fiuorescent spots, seen from the early filling phaseon, corresponded to vascular tufts in the lesion.Vascular tufts were seen only in yellowish-whiteareas. Fluorescein angiography showed the pres-ence of osteoma even in normal-appearing areawhere the retinal pigment epithelium was not sig-nificantly affected, The atrophic areas were char-acterized by dye filling of choroidal vessels andpersistent hyperfluorescence. Fluorescein angiogra-phy was thus a useful adjunct to funduscopy inevaluating the extent and progression of choroidalostteoma.