続発緑内障，網膜出血を伴った慢性関節リウマチの1例

Secondary glaucoma and retinal hemorrhage in a case of rheumatoid arthritis

　69歳女性が両眼の充血と霧視で受診した。高血圧，脳底動脈狭窄症，心筋梗塞，慢性関節リウマチの既往があった。両眼に眼圧上昇があり，強膜炎による続発緑内障と推定した。両眼に網膜出血があった。ステロイド薬点眼で眼圧と眼底所見は正常化した。レーザースペックル法で，治療前に網脈絡膜の血流低下と治療後の血流増加が認められ，強膜炎の治療効果の指標として有用であった。

A 69-year-old female presented with hyperemia and blurring of vision in both eyes. She had been under treatment for systemic hypertension, basilar artery stenosis, myocardial infarction and rheumatoid arthritis. Both eyes showed elevated intraocular pressure (IOP) apparently secondary to scleritis. Retinal hemorrhages were also present in both eyes. Topical corticosteroid for scleritis induced normalization of IOP and fundus findings. Laser speckle method showed decreased chorioretinal blood flow initially and its increase after treatment. This method was useful as a parameter of the therapeutic effect.