コーツ病様変化をきたし高度な滲出性網膜剥離を呈した網膜静脈分枝閉塞症の1例

A case of retinal branch vein occlusion developed exudativ retinal detachment simulating Coats' disease

　69歳女性でコーツ病様の濃厚な滲出物を伴った嚢状の滲出性網膜剥離をきたした網膜静脈分枝閉塞症の1例を報告した．

　右眼上耳側，動静脈交叉部で静脈が閉塞し，毛細血管床閉塞，毛細血管瘤，新生血管を認め，閉塞領域と周囲の網膜血管から強い漏出が見られたが，網膜裂孔は認めなかった．

　網膜下液の排出により嚢状の網膜剥離は消失したが，大量の滲出物のため閉塞領域の血管異常に対する治療が困難だった．

A 69-year-old woman presented with decreased vision in her right eye for the past 2 years. We observed cystic retinal detachment with heavy yellowish-white exudate simulating Coats' disease. No retinal tear was present. Fluorescein angiogra-phy led to the diagnosis of supero-temporal branch retinal vein occlusion associated with capillary nonperfusion areas, microaneurysms and retinalneovascularizations. Late-phase angiograms showed leakage of dye in and around areas affected by retinal branch vein occlusion. The exudative retinal detachment was interpreted as late conse-quence of retinal branch vein occlusion. Fluorescein angiography also indicated macular branch vein occlusion in the fellow eye.

We treated the eye with subretinal fluid drainage, cryoapplication and photocoagulation, with conse-quent disappearance of cystic retinal detachment.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(9) : 1025-1029, 1988