硝子体手術を施行した傍乳頭網膜分離症の1例

Vitreous surgery in a case of peripapillary retinoschisis

（P-2-137）　27歳の女性に左眼視力低下が突発し，その翌日受診した。矯正視力は右1.5，左0.3であった。左眼に，鼻側から乳頭を含み黄斑部に連なる網膜分離症とその一部に網膜剥離があった。黄斑には車軸状の嚢胞があった。網膜裂孔はなく，嚢胞様変性が全周にあった。乳頭鼻側に内層孔と推定される2個の円孔があった。両眼の乳頭は小さく発赤し，乳頭低形成と解釈された。視神経乳頭低形成に伴う傍乳頭網膜分離症に網膜剥離が併発したと考えられ，硝子体切除，強膜輪状締結，眼内光凝固，SF₆ガス注入を行った。網膜分離症と網膜剥離は消失し，0.8の最終視力が得られた。本疾患は，朝顔症候群やpit-macular syndromeのような発生過程での異常が関与していると推測した。

A 27-year-old female presented with sudden blurring in her left eye since the day before. Her corrected visual acuity was 1.5 right and 0.3 left. The left eye showed retinoschisis with partial retinal detachment involving the nasal hemisphere, the optic disc and the macula. Macular cysts were present showing a wheel-spoke appearance. Cystoid degeneration with no retinal hole was present circumferentially. There were two retinal holes nasal to the disc which were interpreted as inner retinal holes. Optic disc hypoplasia was present in both eyes. The left eye was treated by vitrectomy, scleral encircling, intraocular photocoagulation and intravitreal SF₆. Final visual acuity of 0.8 was obtained after disappearance of retinoschisis and retinal detachment. The present case was interpreted as retinoschisis secondary to disc hypoplasia similar to morning glory or pit-macular syndrome.