脈絡膜破裂のある外傷性黄斑円孔への硝子体手術の1例

背景:脈絡膜破裂を伴った外傷性黄斑円孔に対し硝子体手術を行った一例を経験したので報告する.症例と所見:26歳女性,うちあげ花火が直接右眼にあたり鈍的外傷となった.初診時の矯正視力は0.01であり,白内障,前房出血,黄斑円孔,脈絡膜破裂に伴う黄斑下出血と網膜浮腫がみられた.3週間後黄斑円孔は拡大した.6週後の蛍光眼底造影にて黄斑部に及ぶ網膜循環障害を認めた.受傷6週間後にインドシアニングリーンを用いた内境界膜剥離術を行った.黄斑下手術は行わなかった.結果:術後黄斑円孔は閉鎖し,視力は0.5に改善した.重篤な術後合併症は見られなかった.結論:脈絡膜破裂のある外傷性黄斑円孔に対しても硝子体手術は有効であると考えられた.Background: We report a case of traumatic macular hole with choroidal rupture treated with vitrectomy. Case & findings: The patient was a 26-years-old female, who was hit by fireworks in the right eye. At the initial visit, objective symptoms were cataract, hyphema, macular hole, retinal edema, and subretinal hemorrhage following choroidal rupture. Best corrected visual acuity was 0.01 in the right eye. A macular hole developed within 3 weeks, and retinal circulatory disorder was detected in fluorescein angiography. 6 weeks later, pars plana vitrectomy with internal limited membrane peeling using indocyanine green was performed. Sub-retinal procedure in the macular was not included in the surgery. After the surgery, the macular hole was closed, and the best corrected visual acuity in the right eye improved to 0.5. No severe complications were seen postoperatively. Conclusion: Vitreous surgery was effective for traumatic macular hole with choroidal rupture