Epstein-Barrウイルスの関与が疑われた両眼性毛様体剝離の1例

A case of bilateral ciliary detachment suspected of Epstein-Barr virus infection

要約　目的：Epstein-Barrウイルス（EBV）の関与が疑われた毛様体剝離の症例報告。

症例：22歳女性。発熱・咽頭痛の症状で内科受診，EBVによる伝染性単核球症と診断されていた。経過中，急性の両眼視力低下を自覚した。初診時視力は右0.03（0.7×−11.5D（）cyl−0.75D 80°），左0.02（1.0p×−12.25D）であった。眼圧は右21mmHg，左22mmHg。両眼狭隅角・浅前房を認め，中間透光体に混濁や炎症所見はなかった。眼底は両眼後極部に網膜皺襞を認めた。超音波生体顕微鏡（UBM）では両眼とも全周性に毛様体剝離を認め，それに伴う毛様体前方回旋・狭隅角・近視化，水晶体前方移動による硝子体牽引を原因とした網膜皺襞と考えられた。局所加療はせずに経過観察したところ，1週間後に全身症状が改善し，視力も右（1.5×−4.0D（）cyl−0.25D 60°），左（1.5×−4.0D）になった。浅前房は解消され，網膜皺襞も改善した。UBMで毛様体剝離は消失した。

結論：EBV感染の1症例で近視化を伴う一過性の毛様体剝離が発症した。

Abstract　Purpose: To report a case of bilateral ciliary detachment suspected of Epstein-Barr virus infection.

Case: A 22-year-old woman was referred to us for impaired vision in both eyes since 3 days before. She had had fever since 5 weeks before and was suspected of Epstein-Barr virus infection with infectious mononucleosis.

Findings: Visual acuity was 0.7 in the right eye when corrected by −11.5D（）cyl−0.75D 80° and 1.0 left when corrected by −12.25D. Intraocular pressure was 21 mmHg right and 22 mmHg left. Slit-lamp biomicroscopy showed shallow anterior chamber without signs of inflammation in both eyes. Funduscopy and optical coherence tomography showed retinal folds in the posterior fundus. Ultrasound biomicroscopy showed cilioretinal detachment in the whole circumference. The ciliary processes and the lens were anteriorly displaced in both eyes. Her systemic conditions improved one week later with visual acuity of 1.5 in the right eye when corrected by −4.0D（）cyl−0.25D 60° and 1.5 in the left when corrected by −4.0D. Both eyes showed resolution of shallow anterior chamber, retinal folds, and cilioretinal detachment.

Conclusion: This case illustrates that Epstein-Barr virus infection may induce cilioretinal detachment with transient myopia.