広範な脈絡膜循環障害を伴った多発性後極部色素上皮症の1例

A case of posterior multifocal pigment epitheliopathy with impaired choroidal circulation

　広範な脈絡膜循環障害を伴った多発性後極部網膜色素上皮症（以下MPPE）の1例を報告した。症例は基礎疾患を何ら有しない41歳男性で，過去に2回右眼に中心性漿液性網脈絡膜症の診断のもとに治療をうけた既往歴がある。今回両眼は変視症を自覚し，眼所見としては，前眼部には炎症所見は認められず，後極部網膜に扁平な漿液性網膜剥離と，ドーナツ状浸出斑が認められた。螢光眼底撮影では，脈絡膜背景螢光に充満遅延と欠損があり，一部脈絡膜血管も認められた。病変の主座は脈絡膜毛細血管板にあると推測され，網膜色素上皮の変化は，それに続発したものと考えた。

A 41-year-old male presented with bullous retinal detachment in both eyes of a few months' duration. The patient had been diagnosed as central serous chorioretinopathy in the right eye 6 years before. Bilateral micropsia, metamorphopsia and relative central scotoma were chief subjective com-plaints.

There was no evidence of inflammation in the anterior chamber or the vitreous on slitlamp exami-nation. Fluorescein fundus angiography revealed numerous sites of dye leakage from the choroid, suggesting that serous exudation from the choroid into the subretinal space resulted in secondary retinal detachment. Fluorescein angiography also showed multiple areas with delayed or absent chor-oidal filling.

Impaired choroidal circulation seemed to be the underlying pathological feature in posterior multifocal pigment epitheliopathy.