急性網膜壊死に伴う牽引性網膜剝離の治療に光干渉断層計が有用であった1例

Optical coherence tomography was useful in the treatment of traction retinal detachment in a case of acute retinal necrosis

要約　目的：急性網膜壊死に続発した網膜剝離の治療にスペクトラルドメイン光干渉断層計（SD-OCT）が有用であった症例の報告。症例：17歳男性が右眼の充血と眼痛で受診した。矯正視力は左右とも1.2であり，右眼に前眼部の炎症所見と周辺部網膜の白濁と出血，乳頭の発赤があった。急性網膜壊死として抗ウイルス薬と消炎薬を投与したが，硝子体液混濁が増強し，1か月後に硝子体手術を行った。その3週間後に乳頭黄斑領域に網膜剝離が生じ，SD-OCTで乳頭前のWeiss輪による牽引が原因と判断した。硝子体手術で牽引を解除し，網膜剝離は消失した。結論：SD-OCTによる所見は，急性網膜壊死への硝子体手術後に続発した増殖性病変の病態診断に有用であった。

Abstract.　Purpose：To report the usefulness of spectral domain optical coherence tomography（SD-OCT）in a case of acute retinal necrosis with secondary retinal detachment. Case：A 17-year-old male presented with hyperemia and pain in his right eye. Corrected visual acuity was 1.2 in either eye. The right eye showed signs of inflammation in the anterior chamber,opacity and hemorrhage in the peripheral retina,and disc swelling. He was diagnosed with acute retinal necrosis. Vitrectomy was performed one month later due to increased vitreous opacity. Retinal detachment developed in the papillomacular region 3 weeks later. SD-OCT showed a vitreous strand corresponding to the location of Weiss ring as the cause of retinal detachment. Removal of the strand by vitrectomy resulted in disappearance of retinal detachment. Conclusion：SD-OCT was useful in identifying the cause of retinal detachment in a case of acute retinal necrosis.