隅角に大量の色素塊が沈着した太田母斑の1例

Massive pigmentation in the chamber angle in a case of nevus of Ota

要約　目的：隅角に大量の色素沈着があり，緑内障が併発した太田母斑の症例の報告。症例：49歳女性が左眼の霧視で紹介され受診した。過去に左頰部に色素斑があり，2年前にレーザー治療を受けた。前日の左眼眼圧が65mmHgで，降圧薬を使用中であった。所見：左右眼ともほぼ－5.5Dの近視があり，矯正視力は左右とも1.2であった。眼圧は右12mmHg，左23mmHgであった。左眼の虹彩と隅角に顕著な色素沈着があり，下方隅角に大量の色素沈着があった。太田母斑に併発した緑内障と診断した。線維柱帯切開術で眼圧が下降したが，6か月後に再上昇し，線維柱帯切除術の追加と水晶体再建術を行った。結論：太田母斑に併発した緑内障では，線維柱帯切開術による眼圧下降効果が持続しない例がある。

Abstract.　Purpose：To report a case of nevus of Ota with massive pigmentation in the chamber angle and glaucoma. Case：A 49-year-old woman was referred for blurring of vision in the left eye. She had had pigmentation in the left cheek and had received laser treatment for its removal. The lelft intraocular pressure（IOP）was reportedly 65 mmHg on the day before. She had been receiving medication for glaucoma. Findings：Corrected visual acuity was 1.2 in either eye. Both eyes had myopia of about －5.5 diopters. IOP was 12 mmHg right and 23 mmHg left. The left eye showed massive pigmentation in the iris and chamber angle. Pigmentation was more pronounced in the lower quadrant. She was diagnosed with nevus of Ota with secondary glaucoma. Trabeculotomy induced IOP control but trabeculectomy was added 6 months later due to recurrence. Conclusion：This case illustrates that trabeculotomy may have limited effect for glaucoma associated with nevus of Ota.