眼圧上昇を伴った虹彩melanocytomaの1症例

A case of melanocytoma of the iris with ocular hypertension

　開放隅角緑内障を伴った虹彩melanocytomaの1例にsector iridectomyによる腫瘍摘出術を行い眼圧の正常化を得た。

　隅角部に著明な色素沈着を認めたことから，色素あるいはmelanophageの線維柱帯への沈着による眼圧上昇が示唆された。

　虹彩のmelanocytomaとmalignant melanomaの鑑別は臨床的にはきわめて困難であること，また虹彩malignant melanomaは概して予後良好であることから眼圧上昇を伴う症例でも，可能な限りまず薬物による眼圧調整あるいは腫瘍摘出術を試みるべきである。

A 61-year-old male manifested pigmented iris tumor and ocular hypertension in his right eye. The iris tumor was 2×2mm in size and was associated with diffuse pigmentation in the chamber angle. The lesion was treated by sector iridectomy. Post-surgically, the ocular tension normalized withoutmedication. The pigmented iris lesion proved to be melanocytoma. It appeared that the glaucoma was caused by macrophages or dispersion of free pig-ment into the anterior chamber angle. It is advocat-ed that local excision be performed as the first choice in pigmented iris tumors even if glaucomais present.