黄斑部網膜前出血をきたした網膜色素線条症の1例

Premacular hemorrhage in a case of angioid streakes

　25歳男性が右眼視力障害を自覚し，その8日後に受診した。矯正視力は右0.15，左1.0であった。両眼の視神経乳頭周囲に網膜色素線条があり，右眼黄斑部に2.5乳頭径大の網膜前出血があった。3日後に出血の境界面にヤグレーザーを照射し，その後2回の追加を行った。初回照射から3週間後に網膜前出血はすべて消失し，1か月後に矯正視力が0.8に回復した。初診から2か月後に軽度の硝子体出血と網膜前出血が再発したが，11日後に視力は1.0に回復し，6週問後に網膜前出血はすべて消失した。以後1年以上経過した現在まで出血は起きていない。網膜色素線条に合併した網膜前出血に，ヤグレーザーによる後部硝子体膜と内境界膜切開が安全かつ有効であった1例である。

A 25-year-old male presented with visual disturbance in his right eye since 8 days before. His corrected visual acuity was 0.15 right and 1.0 left. Both eyes showed angioid streaks around the optic disc. Premacular hemorrhage, 2.5 disc diameters in size, was present in the right eye. Nd-YAG laser was applied to the margin of premacular hemorrhage 3 days later and was repeated twice. The premacular hemorrhage disappeared 3 weeks after the initial laser application. The visual acuity improved to 0.8 after another one week. Premacular hemorrhage with slight vitreous hemorrhage recurred 2 months after his initial visit but re-solved 6 weeks later resulting in recovery of vision to 1.0. He has been doing well for at least one year of fol-low-up. This case illustrates that photodisruption of the posterior vitreous and internal limiting membrane may be effective for premacular hemorrhage secondary to angioid streaks.