摘出黄斑前膜に類上皮細胞肉芽腫が検出された増殖サルコイド網膜症の1例

Epithelioid cell granuloma in the epiretinal membrane in a case of proliferative sarcoid retinopathy

　64歳男性が3年前に左眼の霧視を自覚し，ぶどう膜炎として点眼治療を続けていた。視力がさらに低下し，当科を受診した。矯正視力は右1.2，左手動弁であり，両眼に虹彩炎と周辺虹彩前癒着があった。左眼に硝子体混濁を認めた。全身検査所見からサルコイドーシスと診断した。左眼に白内障と硝子体手術を行った。採取した黄斑前膜の病理組織学的検索で，類上皮細胞肉芽腫を伴う線維血管膜が同定された。類上皮細胞肉芽腫があることで，増殖サルコイド網膜症の診断を確定することができた。

　Purpose：To report epithelioid cell granuloma found in the epiretinal membrane in a case of sarcoidosis. Design：Interventional case report. Case：A 64-year-old male presented with failing vision since 3 years before. He had been receiving topical corticosteroid under tentative diagnosis of uveitis. His corrected visual acuity was 1.2 right and hand motion left. Both eyes showed signs of iridocyclitis,peripheral anterior synechia,and vitreous opacity. Systemic examinations led to the diagnosis of sarcoidosis. We performed cataract and vitreous surgery in his left eye. Results：Fibrovascular membrane with epithelioid cell granuloma was identified histopathologically in the excised epiretinal membrane. Conclusion：Presence of epithelioid cell granuloma led to the diagnosis of proliferative sarcoid retinopathy.