脈絡膜骨腫の2症例

Two cases of choroidal osteoma

　脈絡膜骨腫を44歳男性の両眼と13歳女性の片眼に経験した。症例1の両眼底には黄斑部に2乳頭径の小さい，症例2の左眼底には視神経乳頭，黄斑部を含む広範囲に黄白色脈絡膜萎縮様病変を認め，その上の網膜は扁平に剥離していた。蛍光眼底造影では両者とも初期から後期にわたり，病巣に一致したびまん性過蛍光が観察された。CTでは病変部に骨と同様のdensityをもつ陰影を認め，超音波検査でも100％近い反射と球後組織の吸収減弱が見られた。以上の所見から2症例を脈絡膜骨腫と診断した。CT，超音波検査が診断に有用であった。1例目は男性で両眼例の小さい病巣で比較的珍しい症例であった。また，6カ月後には，左眼中心窩に脈絡膜新生血管を生じ，クリプトンレーザー光凝固を施行し，瘢痕化させることができた。

We diagnosed bilateral choroidal osteoma in a 44-year-old male and unilateral choroidal osteoma in a 13-year-old girl.The first case manifested a small yellowish-white mass, simulating choroidal atro-phy, in both the maculas. The lesion was about 4 disc diameters across with flat retinal detachment each. In the second case, a similar lesion was locat-ed in the papillomacular area in the left eye. In both cases, fluorescein agniography showed hyperfluor-escence of diffuse pattern over the tumor area throughout the early to late stage. A and B ultrasonographic scans showed solid acoustic shad-owing in the choroid in both cases. Besides charac-teristic fundus findings and ultrasonography, computed tomography was instrumental in estab-lishing the diagnosis. Six months after the initial examination, we found choroidal neovascular-ization in the fovea in the left eye of the first case. The lesion was successfully treated by krypton laser photocoagulation.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(11) : 1229-1234, 1987