広範囲の網膜有髄神経線維に発症した網膜剝離

Retinal detachment involving extensive medullated retinal nerve fibers

目的：広範囲の網膜有髄神経線維がある眼底に発症した網膜剝離2例の報告。症例：38歳男性と43歳女性。男性例には右眼－11D，左眼－14Dの近視があった。左眼に扇状に広がる広範囲の網膜有髄神経線維があり，その両端に網膜裂孔が生じ，網膜剝離になった。硝子体手術で網膜が復位したが，有髄神経線維のある網膜と硝子体との癒着が強かった。女性例は幼少時より右眼視力が不良であった。視力がさらに低下し，黄斑円孔による網膜全剝離が発見された。4象限のそれぞれの方向に扇状の有髄神経線維があった。硝子体手術で網膜が復位したが，有髄神経線維のある網膜と硝子体との癒着が強かった。術後の眼軸長は右眼28.2mm，左眼24.3mmであった。結論：網膜有髄神経線維のある部位と硝子体との癒着が強固であり，網膜硝子体境界面に器質的変化があることが想定される。

Purpose：To report two cases of retinal detachment involving extensive medullated retinal nerve fibers. Cases：One was a 38-year-old man and the other a 43-year-old woman. The first case had myopia of －11 diopters right and －14 diopters left. His left eye showed an extensive fan-shaped area of medullated retinal nerve fibers. Retinal breaks were located on both ends of this area,causing retinal detachment. Firm adhesion was present between this area and the vitreous during vitreous surgery. The second case had poor vision in her right eye since childhood. Further visual impairment led to the detection of macular hole with total retinal detachment. A fan-shaped area of medullated retinal nerve fibers was present in each retinal quadrant. Firm vitreoretinal adhesion was present in these areas. Her optical axis was 28.2 mm right and 24.3 mm left. The retina became reattached in both cases. Conclusion：A firm vitreoretinal adhesion was present in the area of medullated retinal nerve fibers,suggesting the presence of morphological changes in the vitreoretinal interface.