強皮症に随伴した両眼性汎ぶどう膜炎の1例

A case of scleroderma associated with bilateral panuveitis

要約　目的：両眼の汎ぶどう膜炎で発症し，その後強皮症と診断された症例の報告。症例：55歳女性が10日前からの左眼充血と疼痛で受診した。所見：矯正視力は右1.0，左0.5で，左眼に虹彩毛様体炎の所見と乳頭発赤があった。蛍光眼底造影で網膜血管の透過性亢進，光干渉断層計（OCT）で漿液性網膜剝離があった。2か月後に右眼に同様の病変が生じた。次第に手指皮膚の硬化とRaynaud現象が出現し，強皮症と診断された。副腎皮質ステロイドの局所投与で眼所見は10か月後に寛解した。結論：膠原病としての全身症状が顕在化する前に，これと原因的に関連する汎ぶどう膜炎が発症することを本症例は示している。

Abstract.　Purpose：To report a case of bilateral panuveitis who was later diagnosed with scleroderma. Case：A 55-year-old female presented with hyperemia and pain in the left eye since 10 days before. Findings：Corrected visual acuity was 1.0 right and 0.5 left. The left eye showed signs of iridocyclitis and papillitis. Fluorescein angiography showed hyperpermeability of retinal vessels. Optic coherence tomograph（OCT）showed serous retinal detachment. The right eye developed similar symptoms 2 months later. She gradually developed Raynaud phenomenon with hardening of skin of hands and fingers. These findings led to the diagnosis of scleroderma. Ocular lesions subsided after topical treatment with corticosteroid 10 months after her initial visit. Conclusion：This case illustrates that panuveitis may develop before clinical manifestations of underlying collagen disease including scleroderma.