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53歳の男性が2週間前からの霧視で某医を受診した。矯正視力は右0.8,左0.3で,両眼に漿液性網膜剥離があった。病状が悪化し,その5日後に東北大学医学部附属病院眼科を受診した。視力は両眼とも手動弁,眼圧は右64mmHg,左58mmHgで前房はほとんど消失していた。両眼に脈絡膜剥離と広範な胞状網膜剥離があった。血圧は190/90mmHgで,血液検査などで急性腎不全の所見があり,これに続発したuveal effuslon syndromeと診断した。以後10日間に7回の血液透析を行い,眼圧は正常化し,脈絡膜剥離と網膜剥離は消退した。本症候群が急性腎不全で起こり得ることを示す症例である。
A 53-year-old male visited an ophthalmologist for blurring of vison since 2 weeks before. His corrected visual acuity was 0.8 right and 0.3 left. Serous retinal detachment was present in both eyes. When seen by us 5 days later, his visual acuity was hand motion in both eyes. Both eyes showed flat anterior chamber.The intraocular pressure was 64 mmHg right and 58 mmHg left. Both eyes showed extensive bullous retinal detach-ment with choroidal detachment. His systemic blood pressure was 190/90 mmHg. Laboratory studies showed signs of acute renal failure, leading to the diagnosis of secondary uveal effusion syndrome. Ensuing hemodialysis induced improved systemic findings followed by normalized intraocular pressure and disappearance of retinal and choroidal detachments. This case illustrates that uveal effusion syndrome may result from acute renal failure.
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