眼底後極部に円孔が多発した眼内炎の硝子体手術所見

Vitreous surgery for endophthalmitis with multiple holes in the posterior fundus

　症例は16歳男性。木の枝による非穿孔性眼外傷にて，前房蓄膿，硝子体混濁を生じ，硝子体混濁の増強により，硝子体切除術を施行。術中網膜全剥離を認め，術後より再度硝子体混濁が増強したため，当院紹介となった。初診時超音波検査で網膜全剥離を認めたため，輪状締結＋硝子体切除＋液・空気置換＋眼内レーザー＋シリコンオイル注入術を施行。眼底後極部には円孔が多発。網膜血管は著明に怒張・蛇行し，網膜は壊死状となっていた。非穿孔性眼外傷に多発円孔を呈した症例の報告は今までになく，本症は外傷を契機に，急速に何らかの炎症が発症したために生じたものと，推測された。

A 16-year-old boy suffered from blunt eye injury by a branch. The injured eye developed endophthalmitis with hypopyon and vitreous opacity. Vitreous surgery led to detection of total retinal detachment. He was referred to us and underwent another vitreous surgery, scleral encircling, pneumatic retinopexy, endolaser photocoagulation and silicone oil implantation. As intraoperative findings, the retina had become necrotic with multiple round holes in the posterior fundus. Retinal vessels were engorged and tortuous. The present case was unique in developing endophthalmitis following blunt trauma and in manifesting multiple retinal holes.