毛虫の毒針毛による難治性ぶどう膜炎の1例

A case of intractable uveitis induced by urticating hair of caterpillar

要約　65歳男性の右眼角膜が毛虫の毒針毛で刺された。受傷から20か月後に眼痛と視力低下で紹介され受診した。右眼視力は手動弁で，眼圧は47mmHgであった。右眼に瞳孔ブロック，虹彩ルベオーシス，白内障があり，眼底は透見不能であった。虹彩切除などで眼圧は正常化したが，薬物治療にもかかわらず眼内炎は増悪と寛解を繰り返し，前房畜膿が反復して起こった。初診から16か月後に水晶体摘出術を行い，これに続く硝子体切除術の際に硝子体腔から毒針毛を摘出した。眼内炎は消退し，手術から1年経過した現在，0.3の右眼視力を維持している。

Abstract.　A 65-year-old male was stung by urticating hair of caterpillar in his right cornea. He was referred to us for ocular pain and decreased vision 20 months later. His right visual acuity was hand motion. The intraocular pressure（IOP）was 47 mmHg. His right eye showed pupillary block,rubeosis iridis and cataract. The fundus was not visible. Iridectomy induced normalization of IOP but intraocular inflammation repeatedly exacerbated with occasional hypopyon iritis. We performed cataract extraction 16 months after his initial visit. A caterpillar hair was found and removed during ensuing vitrectomy. These procedures induced remission of inflammation,resulting in visual acuity of 0.3 one year later.