光線力学療法後に生じた偽黄斑円孔の1例

Pseudohole of the macula in a case after photodynamic therapy

要約　目的：光線力学療法後に偽黄斑円孔が生じた症例の報告。症例：59歳男性が1か月前からの右眼の霧視で受診した。所見：矯正視力は右0.3，左1.5で，右眼には－3.5Dの近視があった。広範な網膜下出血と黄斑部にポリープ状病巣があった。ポリープ状脈絡膜血管症と診断し，光線力学療法を行った。1週間後に網膜下出血と網膜色素上皮剝離は縮小し，視力は0.7になったが偽黄斑円孔が生じた。以後3か月の間に偽円孔は巾着状から円筒状に変形した。結論：偽黄斑円孔は，光線力学療法によりポリープ状脈絡膜血管症が急速に消退し，網膜外層の形態変化に伴い網膜硝子体界面に求心性の力が作用して生じた可能性がある。

Abstract.　Purpose：To report a case who developed pseudohole of the macula following photodynamic therapy. Case：A 59-year-old presented with blurring of vision in his right eye since one month before. Findings：Corrected visual acuity was 0.3 right and 1.5 left. The right eye was myopic at about －3.5 diopters. The right eye showed a polypoid lesion in the macula with extensive subretinal hemorrhage. The condition was diagnosed with polypoidal choroidal vasculopathy and was treated by photodynamic therapy. One week later,findings simulating pseudohole of the macula appeared after decreased subretinal hemorrhage with visual acuity improving to 0.7. During the ensuing 3 months,the inner edge of pseudohole gradually enlarged to simulate a cylindrical shape. Conclusion：There is a possibility that pseudohole of the macula was induced by deformation of the outer retina with rapid regression of polypoidal choroidal vasculopathy and changes in the vitreoretinal interface after photodynamic therapy.