眼所見から診断された酒さ性角膜炎の2例

Two cases of rosacea keratitis with characteristic ocular manifestations

　特徴的な眼所見から酒さを疑い，2例を酒さ性角膜炎と診断した。いずれも女性で，54歳と57歳であった。1例は2年前から両眼が充血し，点状表層角膜炎と血管侵入を伴い，実質深層に及ぶ周辺部角膜混濁があった。眼瞼縁，鼻尖，頰に血管拡張と毛孔性丘疹があり，皮膚科で第2度酒さと診断された。他の1例には20年前から両眼の充血と眼瞼縁の腫瘤があった。両眼に角膜混濁と血管侵入があり，眼瞼と顔面に血管拡張と丘疹があった。両症例とも，マクロライド系抗菌薬の全身投与と，抗菌薬とステロイド薬の点眼で，眼所見，皮膚所見とも2週後に改善し，点状表層角膜炎は3か月後に消失した。酒さが血管侵入を伴う周辺部角膜混濁の原因となった2例である。

　We diagnosed two patients with rosacea keratitis based on typical ocular findings. Both were females aged 54 and 57 years. One patient had had bilateral hyperemia since 2 years before. Both eyes showed superficial punctate keratitis and corneal opacity with neovascularization. She showed telangiectasia and papiloma in the eyelids and cheeks which were diagnosed as grade 2 cutaneous rosacea. The other patient had recurrent hyperemia and eyelid swelling since 20 years before. Both eyes showed corneal opacity with neeovascularization. She had similar findings on her face. Both patients were treated with systemic macrolides and with instillation of antibiotics and corticosteroid. Both ocular and cutaneous lesions improved in 2 weeks. Superficial punctate keratitis resolved in 3months. These cases illustrate that rosacea may be the cause of peripheral corneal opacity with neovascularization.