乳頭周囲領域の拡大と陥凹を伴う視神経乳頭部先天異常

Congenital optic disc anomalies with enlarged and excavated peripapillary area

　視神経コロボーマ，乳頭周囲ぶどう腫，朝顔症候群およびこれに類似する乳頭形成異常45眼につき乳頭近傍の諸病変を比較検討した．陥凹部周囲の輪状，および下方の舌状の網膜脈絡膜萎縮病変は各異常に高率に認められ，硝子体中の索状物は低率であるが共通に認められた．これらの症例の中にはおのおのの異常の境界例と思われるものがあり，かつ症例によっては諸病変が少しずつ異なることよりこれらの異常は連続性があることが強く推測された．これらは発生機転の程度が違うものか発生時期にずれがあるのかは明らかではないが同一スペクトラム上にあるものと思われた．

We evaluated 45 eyes with congenital optic disc anomalies including optic disc coloboma, peripapil-lary staphyloma, morning glory syndrome and other related conditions. Lesions in the peripapil-lary area were analyzed by fundus photography, fluorescein angiography and echography.

Throughout the present series, annular cho-rioretinal atrophy and areal atrophy inferior to the disc were seen at a high incidence. The latter fea-ture seemed to be related with the embryonic fissure closure. Intravitreal strands were also seen in all the groups, though at a lesser incidence. Some eyes manifested combined features with coloboma, peripapillary staphyloma and/or morning glory syndrome.

The findings indicate that these various anomalies form a continuum along a spectrum of congenital optic disc anomalies.