両眼の漿液性網膜剝離を呈した重症高血圧性網膜症の2例

Two cases of severe hypertensive retinopathy with bilateral serous retinal detachment

要約　目的：両眼に漿液性網膜剝離を呈した重症高血圧性網膜症の2例を報告する。

症例1：38歳，男性。頭痛と倦怠感，両視力低下を主訴にフォークト・小柳・原田病を疑われ当科を紹介され受診した。両眼に漿液性網膜剝離を認め，網膜所見は比較的乏しかった。髄液所見に異常はなく血圧242/127mmHgと異常高値であり，高血圧性網膜症と診断した。

症例2：25歳，女性。両眼に漿液性網膜剝離を認め，乳頭を囲んで出血と浸出斑認めた。血圧180/136mmHgであり高血圧性網膜症と診断した。

結論：両眼に発症した若年者の漿液性網膜剝離をみた場合，網膜所見が比較的乏しい場合でも高血圧性網膜症を念頭に置く必要がある。

Abstract　Purpose：To report two cases of severe hypertensive retinopathy with bilateral serous retinal detachment.

Cases：Case 1 was that of a 38-year-old man presenting with headache, fatigue, and bilateral decrease in visual acuity He was suspected of having Harada disease and was consequently referred to our department. He had bilateral serous retinal detachment with unremarkable retinal abnormalities. Lumbar puncture results were negative；however, his blood pressure was 242/127 mmHg, leading to a diagnosis of hypertensive retinopathy. Case 2 was that of a 25-year-old woman who was referred to our department because of bilateral serous retinal detachment. Retinal bleeding and exudates were observed around the optic disc, and her blood pressure was 180/136 mmHg, resulting in the diagnosis of hypertensive retinopathy.

Conclusion：We must consider the possibility of hypertensive retinopathy in young patients presenting with bilateral serous retinal detachment, even in the absence of remarkable retinal findings.