網膜動脈閉塞を発症した眼内異物の1例

A case of branch retinal artery occlusion caused by an intraocular foreign body

（P−1-105）　52歳の男性の左眼に異物が飛入した。初診時視力は眼前10cm指数弁で，9時の角膜，虹彩，水晶体に異物刺入創，軽度の外傷性白内障を認めた。眼底は硝子体出血により詳細不明であったが，超音波検査，CT検査にて，視神経乳頭近傍の網膜上に鉄片と思われる異物を認めた。明らかな網膜剥離などは認められなかった。翌日，超音波水晶体乳化吸引術と眼内レンズ挿入，硝子体手術，眼内異物摘出術を行った。術中，乳頭部から黄斑上半分を含み，耳側中間周辺部に至る帯状の網膜動脈閉塞を認めた。術後，黄斑前膜の形成をみ，再手術にて除去し，固視点直下に暗点を認めるものの視力0.9を得た。

A 52-year-old male was struck in his left eye while hammering a steel bar. When seen on the same day, the visual acuity was counting fingers. The affected eye showed a penetrating wound in the cornea, iris and the lens at 9 o'clock position. Massive vitreous hemorrhage was also present. Ultrasound and computed tomography showed a foreign body near the optic disc. Pars plana vitrectomy was performed to remove the foreign body and vitreous hemorrhage. The cataractous lens was also removed. Occlusion of retinal artery superior to the disc was found during surgery, apparently due to direct impact by the foreign body. The visual acuity recovered with a small scotoma.