乳糜胸を合併した未熟児網膜症の1例

Retinopathy of prematurity in an infant with congenital chylothorax

要約　目的：先天性乳糜胸があり，出生体重が2,400gを超える新生児に未熟児網膜症が発症した症例の報告。症例：症例は在胎34週4日で生まれた女児で，体重は2,453g，Apgarスコア1/3点であった。在胎26週頃から胎児水腫が進行したため，胸腔穿刺を行い，帝王切開で出生した。出生後，胸腔穿刺，長期間の高濃度酸素投与，NO吸入療法，ステロイド投与を行った。生後50日目に眼科的な検査を受け，zone Ⅱ，stage 3の未熟児網膜症が発見された。両眼の耳側無血管領域に光凝固を行い，網膜症は鎮静化した。結論：高度な呼吸循環障害など全身的なリスクが高い新生児には，できるだけ早期の眼底検査が望まれる。

Abstract.　Purpose：To report an infant who was born with birthweight over 2,400g,who had congenital chylothorax,and who developed retinopathy of prematurity. Case：A female baby was born with gestational age of 34 weeks 4 days,birthweight of 2,453g,and Apgar score of 1/3. She showed progressive fetal pleurisy after 26 weeks of gestation,necessitating drainage of pleural effusion and birth by Caesarian section. During neonatal stage,she received pleural drainage,prolonged oxygen supplement,inhalation of nitric oxide,and systemic corticosteroid. Ophthalmoscopy 50 days after birth showed retinopathy of prematurity that was classified as zone Ⅱ,stage 3. Photocoagulation to the avascular area in the temporal periphery was followed by regression of retinopathy in both eyes. Conclusion：This case illustrates that retinopathy of prematurity is a possibility in an infant with sufficient birthweight and full gestational term when treated by supplemental oxygen for systemic hypoperfusion.