周辺部網膜にみられたドルーゼン様組織の病理学的検討

Histopathology of drusen-like material in the peripheral retina

　生来より角膜混濁，緑内障，強膜ぶどう腫をきたしていた55歳男性の症例に対して眼球内容除去を行い，そのさいに得られた組織を検討した。周辺部網膜には網膜色素上皮細胞下にドーム状に隆起した好酸性の物質の沈着を認め，さらにブルッフ膜の強い肥厚がみられた。これらはPAS染色で陽性で，一部には石灰化もみられた。ドーム状の沈着物はドルーゼンの所見にほぼ一致し，これは周辺部にみられたことから，ora pearlと考えた。この物質が沈着した原因として，加齢によるもののほかに長期に続いた緑内障などの眼内の異常による要因を考えた。

A 55- year-old male presented with intractable pain in his left eye secondary to absolute glaucoma and staphyloma. The affected eye was enuclated and was subjected to histopathological studies. Dome-shaped eosinophilic deposits were present between the Bruch's membrane and the retinalpigment epithelium in the peripheral retina. Bruch's membrane showed marked thickening. The deposits and the Bruch's membrane stained positive for PAS and showed occasional calcifications. These findings were compatible to paripheral drusens or ora pearls. No pathological findings were seen in the sensory retina on normal retinal pigment epithelium. The drusen-like deposits in the peripheral retina appeared to be the consequence of prolonged abnormal conditions such as glaucoma rather than age-related changes.