虹彩上に白色塊が発生し自然消退した1例

A case of spontaneous and transient fluffy white mass on the iris

要約　目的：虹彩前面に白色塊が生じ，自然消退した症例の報告。症例：4歳男児が両眼の眼脂で受診した。顔面と下腿にアトピー性皮膚炎があり，ステロイド軟膏を使用中であった。所見と経過：3か月後に左眼輪部の鼻側下方に血管新生を伴う混濁が生じた。1か月後に混濁は角膜中央部に移動した。さらに3か月後に約3.5×3.5mmの馬蹄形の白色塊が瞳孔縁に接する虹彩前面に生じた。前房に炎症所見はなかった。25日後に白色塊は半透明化し，生じてから45日後に消失した。結論：虹彩前面の白色塊は睫毛由来のfree keratinが関与した可能性がある。

Abstract.　Purpose：To report a case of spontaneous and transient fluffy white mass on the iris. Case：A 4-year-old boy presented with discharge in both eyes. He had been treated by corticosteroid ointment for atopic dermatitis on the face and legs. Clinical Course：Opacity with neovascularization developed near the limbus in lower nasal sector in the left eye 3 months later. The opacity changed its site towards the corneal apex 1 month later. Another 3 months later, a fluffy white mass, 3.5 mm by 3.5 mm in size, appeared on the iris involving the pupillary margin. Signs of inflammation were absent in the aqueous throughout. The white mass became semitransparent 25 days later and disappeared another 20 days later. Conclusion：The observed white mass may have been causatively related with free keratin contained in migrated cilium in the anterior chamber.