急性閉塞隅角緑内障で初発した原田病の1例

Acute angle closure glaucoma as the initial sign in a case of Harada disease

　27歳男性が両眼の視力低下と眼痛を自覚した。眼圧は両眼とも32mmHgで前房が浅く，緑内障の急性発作と診断され，2日後に当科を受診した。超音波生体顕微鏡（UBM）検査で，毛様体上腔に滲出液の貯留，毛様体突起と虹彩根部の前方回旋，水晶体の前方移動があった。眼底は典型的な原田病の所見を呈していた。本症例は，原田病による虹彩根部の前万移動が機序となって発症した閉塞隅角緑内障と考えられた。診断にはUBMが有用であった。

A 27-year-old male developed sudden bilateral visual blurring with ocular pain. The intraocular pressure was 32 mmHg in either eye with shallow anterior chamber when seen by an ophthalmologist. He was diagnosed as acute glaucoma and was referred to us two days later. Ultrasound biomicroscope (UBM) showed suprachoroidal effusion, anterior rotation of the ciliary processes and iris root, and anterior displacement of the lens. Funduscopy showed typical features of Harada disease. The angle closure glaucoma appeared to have been induced by anterior displacement of the iris root due to Harada disease. Examination by UBM was useful in establishing the diangosis.