ピット黄斑症候群の硝子体手術後に生じた黄斑円孔が閉鎖した1例

Closure of macular hole that developed after vitreous surgery for pit-macular syndrome without additional treatment

要約　目的：ピット黄斑症候群に硝子体手術を行った後に生じた全層黄斑円孔が追加治療を要さずに閉鎖した症例の報告。症例：78歳女性が1か月前からの左眼視力低下で受診した。矯正視力は右0.8，左0.1で，左眼視神経乳頭から黄斑にかけて網膜分離，乳頭耳側に乳頭小窩，黄斑部に網膜剝離と外層円孔があり，ピット黄斑症候群と診断した。硝子体手術とSF₆によるガスタンポナーデを行った。経過：術後2か月で黄斑の外層円孔が全層円孔になった。黄斑部の網膜剝離の減少に伴い，術後7か月で黄斑円孔は閉鎖した。術後21か月の現在まで経過は良好で，左眼視力は0.7を維持している。結論：ピット黄斑症候群に硝子体手術を行った後に生じた全層黄斑円孔は，黄斑部網膜剝離の減少により閉鎖する可能性があることを本症例は示している。

Abstract.　Purpose：To report a case of pit-macular syndrome that developed into full-thickness macular hole after vitreous surgery and that closed later without additional treatment. Case：A 78-year-old woman presented with impaired vision in the left eye since one month before. Corrected visual acuity was 0.8 right and 0.1 left. The left eye showed retinoschisis in the papillomacular area,a pit in the optic disc,and retinal detachment with macular hole in the outer layer. She was diagnosed with pit-macular syndrome and received vitreous surgery with gas tamponade. Clinical Course：Full-thickness macular hole developed 2 months after surgery. It closed spontaneously along with decrease in retinal detachment in the macular area. There has been no recurrence for 21 months until present with visual acuity of 0.7. Conclusion：This case illustrates that full-thickness macular hole may develop after vitreous surgery for pit-macular syndrome and that it may close later without additional treatment.