真菌性眼内炎に併発した裂孔原性網膜剥離の2例

Two cases of rhegmatogenous retinal detachment secondary to fungal endophthalmitis

　内因性真菌性眼内炎に裂孔原性網膜剥離を併発した2症例を経験した。症例1は，胆石，胆嚢炎，十二指腸閉塞にて胆嚢摘出および十二指腸空腸吻合術後，中心静脈高カロリー輸液（IVH）を長期留置していた。症例2は，Sjögren症候群，続発性腎性尿崩症，遠位尿細管性アシドーシス，急性膵炎および急性心内膜炎にて副腎皮質ステロイド療法およびIVHの長期留置を行っていた。2例とも，抗真菌剤の全身投与と手術により網膜の復位を得た。真菌性眼内炎に併発した網膜剥離を認めた場合，牽引性のみならず裂孔原性も存在し，しかも，その手術予後は比較的良いと考えた。

Two patients, a 72-year-old male and a 45-year-old female, developed rhegmatogenous retinal detachment secondary to endogenous fungal endophthalmitis. The first case had been treated by intravenous hyperalimentation after surgery for ileus, cholelithiasis and cholecystitis. The second case had been treated by systemic corticosteroid and intravenous hyperalimentation for Sjögren syndrome, renal diabetes in-sipidus, distal tubular acidosis and acute pancreatitis. Retinal detachment was achieved in both cases by systemic antifungal agent and surgery. The present cases illustrate that rhegmatogenous retinal detachment may be caused by fungal endophthalmitis and that it responds favorably to treatment.