重症太陽性網膜炎の1例

A case of severe solar retinopathy

（P1-3-1）　31歳の女性が，晴天の海岸で長時間読書したあとに左眼の変視症を自覚した。翌日他医に眼底出血を指摘され，その1か月後に受診した。左眼矯正視力は0.6であり作中心窩に黄灰色の小点があり，網膜出血，網膜下出血と光凝固斑後に好発する白色斑を伴い，これらを含む範囲に漿液性色素上皮剥離があった。太陽性網膜炎と診断した。右眼は正常であった。フルオレセイン螢光造影で，網膜神経上皮下の色素漏出と小点部の過螢光があり，走査レーザー検眼鏡の波長780nm単色光で，小点部は周囲の網膜よりも高輝度を呈した。以上の所見から，左眼の障害部位は網膜色素上皮層と脈絡膜にあると解釈した。

A 31-year-old female noted metamorphopsia in her left eye after prolonged reading in the beach in a clear day. Fundus hemorrhage was detected the next day. When seen by us one month later, the corrected visual acuity was 0.6 left. Funduscopy showed a yellowish gray spot in the fovea surrounded by retinal and subretinal hemorrhage and by white spots simulating those after photocoagulation. A serous detachment of retinal pigment epithelium was present including these areas. We diagnosed the condition as solar retinopathy. Her right eye showed normal findings. Fluorescein angiography showed dye leakage posterior to the neuroepithelium and hyperfluorescence from the foveal spot. Observation with monochromatic light with the wavelength of 780 nm showed a higher reflectibility in the foveal spot. These findings indicated that the affected lesion was located in the retinal pigment epithelium and the choroid.