光干渉断層計が診断に有用であった網膜および網膜色素上皮過誤腫の1例

A case of hamartoma of the retina and retinal pigment epithelium diagnosed with the aid of optical coherence tomography

要約　目的：光干渉断層計（OCT）が診断に有用であった網膜および網膜色素上皮過誤腫の1例の報告。

症例：11歳男児が左眼視力低下で紹介受診した。6年前から斜視で近医に通院し，1年前の矯正視力は右1.2，左1.0であった。最近になり硝子体黄斑牽引症候群が疑われた。

所見と経過：矯正視力は右1.5，左0.15で，右眼に＋3.5D，左眼に＋1.5Dの遠視があった。右眼には異常がなく，左眼に乳頭周囲の血管が鼻側に牽引される乳頭逆位があった。乳頭黄斑間に黄色調の隆起があり，毛細血管が拡張していた。フルオレセイン蛍光眼底造影で色素の貯留があり，OCTで網膜が肥厚し，網膜外層に色素上皮の腫瘤があった。網膜および網膜色素上皮過誤腫と診断した。以後3年後の現在まで所見は変化していない。

結論：網膜および網膜色素上皮過誤腫の診断に，OCTが有用であった。

Abstract　Purpose：To report a case of hamartoma of the retina and retinal pigment epithelium diagnosed with the aid of optical coherence tomography（OCT）.

Case：A 11-year-old boy was referred to us for impaired vision in the left eye. He had been followed up for strabismus since 6 years at an ocular clinic nearby. Visual acuity one year before was reportedly 1.2 right and 1.0 left. He had been recently suspected of vitreomacular traction syndrome.

Findings and Clinical Course：Corrected visual acuity was 1.5 right and 0.15 left. The right eye had hyperopia of ＋3.5 diopters and the left eye of ＋1.5 diopter. The right eye showed no abnormal finding. The left eye showed traction of major retinal vessels near the disc in the nasal direction, manifesting inversed disc. A yellow elevation was present between the disc and the macula with dilated capillaries. Fluorescein angiography showed dye pooling. OCT showed thickened neural retina and retinal pigment epithelium. The findings led to the diagnosis of hamartoma of the retina and retinal pigment epithelium. There has been no change in the findings for 3 years until present.

Conclusion：OCT was useful in the diagnosis of hamartoma of the retina and retinal pigment epithelium.