出血性色素上皮剝離を伴った網膜色素線条の2例

Two cases of angioid streaks with hemorrhagic detachment of retinal pigment epithelium

要約　目的：網膜下出血と出血性色素上皮剝離が合併した網膜色素線条症2例の報告。症例：1例は74歳男性で，飛蚊症を契機として網膜色素線条と，両眼の中心窩耳側に網膜下出血が発見された。経過観察中に左眼，その8か月後に右眼に出血性色素上皮剝離が生じた。治療により右眼は瘢痕治癒したが，左眼には硝子体出血が生じ，光覚弁になった。ほかの1例は62歳女性で，左眼視力低下を契機として両眼に網膜色素線条，左眼に新生血管黄斑症が発見された。その3か月後に右眼に出血性色素上皮剝離が生じたが，加療により瘢痕治癒した。左眼には経瞳孔温熱療法ののち出血性色素上皮剝離が発症した。血腫は吸収されたが，最終視力は0.04であった。結論：網膜色素線条には新生血管黄斑症が併発し，出血性色素上皮剝離または硝子体出血になることがある。

Abstract.　Purpose：To report two cases of angioid streaks followed by hemorrhagic detachment of retinal pigment epithelium（RPE）. Cases：A 74-year-old male received funduscopy and was diagnosed with angioid streaks and subretinal hematoma in both eyes. During the follow-up,hemorrhagic RPE detachment in the left eye and,8 months later,in the right eye. The fundus lesion was brought to cure in the right eye. Massive vitreous hemorrhage developed in the left eye and resulted in final visual acuity of light perception. Another 62-year-old female presented with decreased visual acuity in her left eye. She was diagnosed with angioid streaks in both eyes and neovascular maculopathy in the left. Hemorrhagic RPE detachment developed later in both eyes. Useful vision was preserved in the right eye only. Conclusion：Angioid streaks may be followed by neovascular maculopathy that later develop multiple hemorrhagic RPE detachment or vitreous hemorrhage.