老人性円板状黄斑変性症の大型網膜色素上皮剥離から自然発生した網膜色素上皮裂孔の3例

Spontaneous tear in detached retinal pigment epithelium in three cases of age-related macular degeneration

　過去6年間に老人性円板状黄斑変性症で大型の網膜色素上皮剥離を伴った網膜下嚢胞型と診断された症例55例57眼のうち，光凝固を行わなかった例で特発性に網膜色素上皮裂孔を発生したのは31眼中3眼10％あった。網膜色素上皮裂孔は色素上皮剥離発生の4〜9か月後に生じ，網膜色素上皮剥離の大きさは，2ないし4乳頭径と大きく，2例は裂孔発生時に色素上皮剥離の拡大をみた。2例は，裂孔の発生時に自覚症状がなく，かつその後も軽い反応性の線維性増殖しか起こらなかったので，良好な視力を維持した。1例は裂孔部に，強い反応性の線維性増殖が起こって視力が低下した。特発性網膜色素上皮裂孔の3例について発生と経過を報告した。

We reviewed as series of 67 eyes, 65 patients, with detachment of retinal pigment epithelium associat-ed with age-related macular degeneration seen by us during the past 6 years. Spontaneous tear of retinal pigment epithelium developed in 3 out of 31 eyes without laser treatment, 11%. The tear waslocated in the macula in all the 3 eyes. The size of pigment epithelial detachment was 4 disc diameters (DD) in one eye. It was 2 DD initially in 2 eyes and had developed to 4 DD when the tear developed. Tear formation was followed by marked subretinal proliferation in one eye. In the other 2 eyes, the tear was covered by mild fibrous membrane with full visual acuity.