正常な電気生理学的所見で白点状眼底様所見を呈する1例

A case simulating fundus albipunctatus with normal electrophysiological findings

要約　目的：高解像度光干渉断層計（OCT）で白点状眼底様の眼底所見を呈し，電気生理学的に正常な症例の報告。症例：65歳女性が健康診断で緑内障様の視野異常を発見され，精査を求めて受診した。所見：矯正視力は左右眼とも1.5で，両眼の眼底に無数の白点があった。蛍光眼底造影で白点の部位に一致して淡い過蛍光があった。視野，暗順応，網膜電図には異常がなく，高解像度光干渉断層計では網膜色素上皮から視細胞の内外節接合部に向かう高反射があった。以後5年間の経過中に所見の変化はない。結論：本症例は停在性の白点状眼底様の眼底所見を呈し，視機能には異常がなく，網膜色素上皮に変性があることが推定される。

Abstract.　Purpose：To report a case simulating fundus albipunctatus by high-definition optical coherence tomography（OCT）with normal electrophysiological findings. Case：A 65-year-old woman visited us for precise diagnosis after visual field defect was found by health-check program. Findings：Corrected visual acuity was 1.5 in either eye. Both eyes showed numerous white dots simulating fundus albipunctatus. Fluorescein angiography showed faint hyperfluorescence corresponding to the site of white dots. No abnormalities were detected regarding visual field,dark adaptation or electroretinogram. OCT showed enhanced reflex between the retinal pigment epithelium and line of junction between outer and inner segments of visual cells. There has been no change during the follow-up for 5 years. Conclusion：Degeneration of the retinal pigment epithelium may be present in the present case that shows findings simulating fundus albipunctatus with normal visual function and electrophysiological findings.