原発性Fuchs角膜内皮ジストロフィの1例

A case of primary Fuchs' corneal endothelial dystrophy

　6年前，59歳女性が30歳頃からの目のかすみと充血で受診した。両眼角膜内皮障害による角膜浮腫と診断し，このとき以来，両眼角膜中央にcornea guttata，角膜後面沈着物と実質の浮腫混濁が認められている。左眼には小水疱を伴う上皮浮腫が生じたが，ソフトコンタクトレンズ装用で自覚症状は改善した。現在の矯正視力は左右とも0.3である。スペキュラーマイクロスコピーで多数のdark areaと内皮細胞の大小不同がみられた。虹彩炎は過去6年間まったくみられなかった。本症例は日本ではまれな原発性Fuchs角膜内皮ジストロフィと診断した。

A 59-year-old female presented with blurring and hyperemia in both eyes as chief complaints since the age of 30. She had been diagnosed as bilateral corneal edema secondary to endothelial impairment for 6 years. She had reportedly developed bilateral corneal guttata, keratic precipitates and stromal edema. Wearing of soft contact lens induced improvement in subjective symptoms. Her corrected visual acuity was 0.3 in either eye. Specular microscopy showed numerous dark areas and irregularity in the size of endothelial cells. There has been no iritis during the past 6 years. This case was diagnosed as primary Fuchs' corneal dystrophy which is unusual in the Japanese.