アトピー性皮膚炎に伴った網膜剥離の検討—外傷との関連性について

Trauma-induced retinal detachment with atopic dermatitis

　過去9年間に，アトピー性皮膚炎を伴った網膜剥離16例22眼を経験した。うち17眼に硝子体基底部のテント状剥離を伴った硝子体基底部裂孔があり，そのうち3眼は赤道部に変性巣とは別の裂孔を伴っていた。これらは臨床的または実験的な外傷性裂孔と一致していた。外傷を示唆する隅角離開を10眼，水晶体亜脱臼を3眼，風車状白内障を5眼に認めた。これらの患者の性癖を調査すると，アトピー性皮膚炎で網膜剥離を伴わないコントロール群に比べて，眼を叩く性癖を持つ者が有意に多かった。以上より，アトピー性皮膚炎に伴う網膜剥離の主原因は外傷であると考えられ，眼を強くこすったり，叩いたりしないような指導が必要であると考えられた。

We treated 22 eyes with retinal detachment in 16 cases of atopic dermatitis during the foregoing 9 -year period. We observed retinal breaks along the vitreous base in 17 eyes, of which 3 eyes showed additional retinal breaks in the equator. These breaks closely simulated trauma-induced retinal breaks seen clinically and experimentalliy. No retinal break could be detected due to severe proliferative vitreoretinopathy (PVR), but breakswere suspected to lie in the farthest periphery. Only one out of the 22 eyes in the series was associated with lattice degeneration of the retina.

As other features suggestive of ocualr trauma, we detected angle recession in 10 eyes, rosette cataract in 5 and subluxation of the lens in 3.

Tapping or rubbing the itchy eyes due to atopic dermatits appeared to be the chief cause of ocular trauma. We observed a statistically high incidence of tapping or rubbing the eye in the present series as compared with another group of 17 patients with atopic dermatitis but without retinal detachment.