Coats病精査を契機に眼底所見から先天性上斜筋麻痺を診断した1例

Congenital superior oblique palsy in a case of Coats disease

要約　目的：Coats病の精査を契機に眼底所見から先天性上斜筋麻痺が診断された症例の報告。症例：8歳男児が右眼視力の低下で受診した。所見：矯正視力は右0.9，左1.5であり，右眼の下鼻側に白斑沈着を伴う網膜剝離があり，Coats病と診断した。眼底写真から右眼の外方回旋があり，上斜筋麻痺と診断した。頭位異常はなかった。左眼遮蔽と右眼への光凝固を行ったが，牽引性網膜剝離が増加した。6か月後に局所バックリングを行い網膜は復位した。右眼の外方回旋は牽引による中心窩偏位で増加した。結論：小児の網膜疾患では，ほかに別の問題があることがあるので注意が必要である。

Abstract.　Purpose：To report a case of Coats disease associated with ipsilateral superior oblique palsy. Case：An 8-year-old male was referred for recently impaired visual acuity in the right eye. Findings：Corrected visual acuity was 0.9 right and 1.5 left. The right eye showed retinal detachment with exudates in the inferior nasal periphery. The findings were suggestive of Coats disease. Excyclodeviation of the right eye was detected by fundus photography. The condition was diagnosed with congenital superior oblique palsy. The patient showed no abnormal head posture. The retina became reattached after localized scleral buckling. Excyclodevision of right eye progressed due to foveal exotopia induced by detachment surgery. Conclusion：This case illustrates that retinal disorder in children may be associated with other abnormal conditions.