成人型封入体結膜炎の輪部・角膜病変

Limbal and corneal involvement in adult inclusion conjunctivitis

　成人型封入体結膜炎49例を対象に，輪部・角膜病変について検討した。上輪部浸潤は49例中31例（63％）にみられ，発病2週間以内では23例中18例（78％）であった。上方からの軽度の血管侵入は7例（14％）に観察された。角膜にはびまん性あるいは小円形の上皮下混濁が49例中31例（63％）に認められ，発病2週間以内では23例中19例（83％）と高率であった。これらの角膜上皮下混濁は上方周辺部に多く，表面はフルオレセインに染色されなかった。成人型封入体結膜炎では，発病初期に高頻度に輪部・角膜病変がみられ，これらの病変はアデノウイルス結膜炎との鑑別診断上，重要な所見と考えられた。

We studied limbal and corneal changes in 49 cases of adult inclusion conjunctivitis. Superior limbal infiltration was observed in 31 cases (63%), seven of which showed mild focal pannus. Corneal changes consisting of diffuse or small round subepithelial opacities were noted in 31 cases (63%), showing predominant involvement of the upper third of the cornea, and no staining with fluorescein. These changes were common even in the cases less than two weeks after the onset of conjunctivitis; there was limbal infiltration in 18 of 23 cases (78%), and subepithelial opacities in 19 of 23 cases (83%). Limbal and corneal changes with a tendency toward involvement of the upper sites and early occurrence of subepithelial opacities should be helpful in the clinical differentiation of chlamydial and adenoviral conjunctivitis.