網膜中心静脈閉塞症様所見を呈した術後眼内炎の1例

A case of postoperative endophthalmitis simulating central retinal vein occlusion

（P1-2-37）　白内障術後に非典型的症状を呈した感染性眼内炎の1例を経験した。症例は47歳，男性で，左眼成熟白内障にて超音波乳化吸引術およびfoldable眼内レンズ挿入術を行った。術後1日目の矯正視力は1.2，術後17日目に視力低下・眼痛・頭痛を自覚した。矯正視力は10cm指数弁となっており，眼圧55mmHg，前房は深く，細胞・フレアー著明で茶色羽毛状滲出物がみられたが，前房蓄膿はみられなかった。術後感染性眼内炎を疑い，診断的・治療的硝子体手術を行った。術中眼底には数時間前にはみられなかった網膜中心静脈閉塞症様の網膜斑状出血と白斑が多数みられた。術後，眼内炎の再燃はなく，矯正視力は0.8まで回復し，網膜出血および白斑も消失した。

A 47-year-old male underwent uneventful surgery for mature cataract in his left eye by phacoemulsification-aspiration and insertion of foldable intraocular lens. The corrected visual acuity was 1.2 on the day after surgery. Ocular pain and headache developed on day 17 of surgery. The visual acuity was finger counting. Intraocular pressure was 55mmHg. The anterior chamber showed signs of inflammation and no hypopyon. Vitreous surgery was performed under the tentative diagnosis of postoperative intraocular infection. During surgery, the fundus showed numerous hemorrhagic patches and soft exudates simulating central retinal vein occlusion. These findings were absent a few hours before surgery. The postsurgical course was uneventful with the recovery of vision to 0.8 and disappearance of retinal hemorrhages and exudates.