片眼性網膜色素変性症に合併した黄斑円孔が自然閉鎖した1例

Spontaneous closure of the macular hole in unilateral retinitis pigmentosa patient：a case report

要約　目的：片眼性網膜色素変性症（RP）に囊胞様黄斑浮腫，その後黄斑円孔（MH）を生じ，自然閉鎖を認めた症例の報告。

症例：35歳女性が左眼の視力低下を主訴に受診した。

所見：矯正視力は右1.2，左0.2で，眼圧は右16mmHg，左13mmHgであった。左眼眼底にのみ骨小体様色素沈着および囊胞様黄斑浮腫を認め，左眼の網膜電図が平坦で，片眼性RPと診断した。左眼に1％ブリンゾラミドの点眼を1日2回行ったが，7か月後に全層MHを生じ，MH発生2か月後にMHは自然閉鎖した。その後，MHの再発は認めず，左矯正視力は0.4と軽度の上昇を認めた。

結論：若年の片眼性RPのMHでは，経過観察で自然閉鎖を期待しうる可能性が示唆された。硝子体手術による介入は慎重であるべきと考えられる。

Abstract　Objective：To report a case of unilateral retinitis pigmentosa（RP）with cystoid macular edema, followed by macular hole formation, and spontaneous closure.

Case：A 35-year-old woman presented with visual loss in her left eye.

Findings：The corrected visual acuity was 1.2 on the right and 0.2 on the left, while the intraocular pressure was 16 mmHg on the right and 13 mmHg on the left. Bone spicule-like pigment clumping, and cystoid macular edema were observed only in the fundus of the left eye. The electroretinogram of the left eye was non-recordable, leading to the diagnosis of unilateral RP. Brinzolamide 1％ was applied to the left eye twice a day, but a macular hole occurred 7 months later. Two months after macular edema occurred, the macula hole of the left eyes spontaneously closed. After that, no recurrence of macular hole was observed, and the left-corrected vision increased slightly to 0.4.

Conclusion：This case report demonstrated that unilateral RP with a macular hole in young patients may spontaneously close. As such, vitreous surgery should be applied carefully in these cases.