知的障害者にみられた網膜剝離

Retinal detachment in mentally retarded persons

要約　目的：知的障害者に発症した網膜剝離の特徴と治療結果の報告。対象：過去7年3か月間に網膜剝離を治療した知的障害者7例12眼を検索した。結果：男性6例，女性1例で，5例が両眼性であった。年齢は10～44歳（平均22歳）であった。自分の眼や顔を叩くなどの自傷行為が4例7眼にあった。網膜全剝離または網膜下増殖を伴って発見される例が多く，白内障が9眼に併発していた。手術を行った11眼中10眼ではシリコーンオイルを併用する硝子体手術を必要とし，10眼（91％）で復位が得られた。結論：知的障害者の網膜剝離には外傷性が多く，陳旧または難治なものがあり，治療では家族，精神神経科，麻酔科との連携が重要である。

Abstract.　Purpose：To report the characteristic features and therapeutic outcome of retinal detachment in mentally retarded persons. Cases：This review was made on 12 eyes of 7 mentally retarded persons who had retinal detachment seen during past 7 years 3 months. Results：The series comprised 6 males and 1 female. Retinal detachment was bilateral in 5 cases. The age ranged from 10 to 44 years, average 22 years. Seven eyes of four patients had the habit of self-inflicted ocular contusion. The retinal detachment was characterized by late detection resulting in total retinal detachment or subretinal proliferation. Cataract was present in 9 eyes. Out of 11 operated eyes, 10 eyes needed vitrectomy with silicone oil tamponade. The retina became reattached in 10 eyes（91％）. Conclusion：Retinal detachment in mentally retarded persons has characteristic findings of traumatic retinal detachment and tends to be severe due to late detection. There is an urgent need of cooperation with the family, psychiatrists and anesthesiologists for the treatment to succeed.