特異な経過を示した網膜色素上皮剥離症例

A case of detachment of the retinal pigment epithelium with unusual clinical course

　大型の網膜色素上皮剥離（pigment epithelial detachment：PED）の縮小に伴い，放射状脈絡膜ひだ，色素上皮裂孔を合併した1例のインドシアニングリーン螢光眼底造影所見（indocyanine greenanglography：IA）を検討した。症例は69歳，女性。初診時両眼底後極部には大型のPEDを認め，左眼底にはPEDに接して耳上側に小型のPEDを認めた。IAではPEDは不規則低螢光を示した。約4か月後，左眼のPEDは縮小し，これに向かう放射状脈絡膜ひだがみられたが，IAでは脈絡膜ひだの中央部分に脈絡膜新生血管板は検出されなかった。30か月後の現在，脈絡膜ひだは増加し，中央部の色素上皮下液は濃縮して白色になり，一部色素上皮裂孔を生じた。本症例では明らかな脈絡膜新生血管を伴わない脈絡膜ひだが，加齢黄斑変性症に発生していた。

A 69-year-old female presented with retinal pigment epithelial detachment (PED) in both eyes. The PED was located in the posterior fundus and was 4 disc diameters in either eye. A small PED was also present upper temporal to the lesion in the left fundus. The initial visual acuity was 0.9 right and 0.6 left. Indocyanine green angiography showed irregular hypofluorescence in the area of PED. Four months later, the PED in the left eye became reduced in size surrounded by radial chorioretinal folds. Another 26 months later, the radial choroidal folds increased in number. The PED became whitish due presumably to condensation of the fluid posterior to the PED. A tear of the retinal pigment epithelium had developed. There was no angiographic or funduscopic evidence of choroidal neovascular membrane throughout the period of observation.