28カ月間良好な網膜機能を保った眼球銅症の1例

A favorable course of a case with ocular chalcosis

　硝子体中に銅片を確認したが，視機能良好なため2年半の長期間保存的に観察できた眼球銅症の1例を報告した．41歳男性の左眼に銅線の破片が飛入し，角膜中央の裂傷と水晶体の周辺部に飛入点を認める他は損傷はなく，後部硝子体中に微小異物が観察された．受傷18カ月後，水晶体の後嚢全体に軽度の緑褐色沈着を認め，19カ月後，硝子体混濁が増強し異物が確認できなくなった．しかしERGは，全経過を通じて左右差が認められず視力も1.2のままであった．28カ月後，硝子体融解とともに異物が水晶体後方に認められたため，vitrectomyを施行し異物を摘出した．摘出異物は長径1mmほどで，ICP発光法で銅含有量98％と判明した．

　本例で銅の純度が高いにもかかわらず，網膜機能が良好であったのは，銅異物が小さく，網膜損傷がないことなどによると考えられた．

A 41-year-o1d male was struck in the left eye with a piece of copper wire, which shot through the cornea and the lens to be located in the posterior vitreous. Cataract failed to develop during the following 28 months. Visual acuity, color sense and electroretinographic findings remained normal. As the vitreous opacity increased and the foreign body gradually advanced to reach the posterior lens surface, we undertook vitrectomy with extraction of the foreign body 28 months after the injury. The foreign body was comprised of pure copper. Thiscase failed to manifest retinal toxicity, suggesting that a tiny copper foreign body in the vitreous is not necessarily deletrious to the retina.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(2) : 172-175, 1988