人工透析を行なつた腎炎性網膜症の1剖検例

Histological Changes of Renal Retinopathy after Long-term Hemodialysis

緒　言

　慢性腎不全例に対する人工透析の臨床的価値が不動のものとなり，わが国においてもようやく好成績が得られるようになつて来た^1）。しかし人工透析による慢性腎不全例の長期延命，社会復帰が可能になるとともに，眼科学的にもいくつかの間題が生ずるに至つた。すなわち人工透析による腎炎性網膜症の病態の変化および視機能に及ぼす影響がそれであり，それらの問題点を十分に検討することが人工透析の成果を完全ならしめる上に必要となつて来た。

　しかしわが国における人工透析の歴史はまだ浅いため，これらに関する研究は非常に少い。とくに眼球の剖検まで行なつた例は，われわれの発表以来，山之内^2），高橋^3）の報告を入れて，わずか4症例にすぎない。

A case with renal retinopathy, who had un-dergone hemodialysis 212 times during 18 mo-nths before death, was reported. The patient, a 30-year-old male, had a transient recovery from the retinopathy and uremia by the treat-ment, but finally he became almost blind due to vitreous haemorrhage and endophthalmitis and he died of sepsis. Both eyes were enucle-ated at the autopsy. The retinal blood vessels, both arterioles and venules, became extremely narrow and appeared as white lines. Histolog-ical sections showed complete loss of receptor cells, degeneration of the retinal pigment epit-helium and atrophy of the sclera and choroid.