未熟児網膜症自然治癒31年後に発症した裂孔原性網膜剝離の1例

Rhegmatogenous retinal detachment 31 years after spontaneous cure of retinopathy of prematurity

　31歳女性に右眼の視力低下が突発した。28週での早産児で，出生時体重は1,050gであった。両眼に未熟児網膜症があり，右眼は自然治癒し，左眼は失明した。右眼の以後の経過は良好で，高度近視があったが，コンタクトレンズ装用で0.7の視力があったという。幼少時にアトピー性皮膚炎があった。右眼に硝子体出血と網膜全剝離があり，中間周辺部の網膜硝子体癒着が強かった。左眼に牽引乳頭と胞状網膜剝離があり，未熟児網膜症の瘢痕4期に相当した。右眼への手術中に，分界線（demarcation line）よりも後方の有血管網膜部位に小さな円孔を確認した。0.8の最終視力を得た。無治療で自然寛解した未熟児網膜症による網膜剝離が，成人になって発症した1例である。

　A 31-year-old female presented with sudden blurring in her right eye. She had been born prematurely after gestation of 28 weeks weighing 1,050g. Retinopathy of prematurity（ROP）had developed in both eyes. It subsided spontaneously in the right eye and resulted in blindness in the left. The right eye had visual acuity of 0.7 when corrected for high myopia. Atopic dermatitis had been present during childhood. The right eye had vitreous hemorrhage,tight vitreoretinal adhesion in the midperiphery,and total retinal detachment. The left eye showed bullous retinal detachment corresponding to stage 4 of cicatricial ROP. During surgery,a small round hole was identified in the vascularized retina posterior to the demarcation line. It was an unusual finding for an eye with untreatd ROP. This case illustrates that untreated ROP may induce rhegmatogenous retinal detachment after adulthood.