硝子体混濁を主症状としたFuchs虹彩異色毛様体炎の2例

Two cases of Fuchs heterochromic iridocyclitis with vitreous opacity as the outstanding clinical manifestation

要約　目的：硝子体混濁を主な臨床所見としたFuchs虹彩異色虹彩毛様体炎（Fuchsぶどう膜炎）の2症例の報告。症例：症例は33歳女性と32歳男性で，いずれも片眼性である。症例1は5年前に虹彩炎と硝子体混濁を指摘され，ベタメタゾン点眼で虹彩炎は軽快していた。症例2は8か月前に霧視が生じ，次第に悪化していた。所見と経過：患眼の矯正視力は，それぞれ1.0と0.7であった。症例1には軽度の角膜後面沈着物と中等度の硝子体混濁があった。原因不明のぶどう膜炎としてベタメタゾンの点眼を行った。2週間の点眼中止時に，特徴的な角膜後面沈着物，虹彩萎縮，虹彩結節が発見され，Fuchsぶどう膜炎と診断した。症例2には軽度の虹彩萎縮，後囊下白内障，強い硝子体混濁があった。前房水と血液の風疹ウイルスの抗体が高値であり，Fuchsぶどう膜炎と診断した。硝子体切除を行い，霧視は消失し，視力は1.0に向上した。結論：Fuchsぶどう膜炎の2症例で，硝子体混濁が主要な臨床所見であった。

Abstract.　Purpose：To report 2 cases of Fuchs heterochromic iridocyclitis with vitreous opacity as the outstanding clinical feature. Cases：One was a 33-year-old female and the other was a 32-year-old male. Both were unilaterally affected. Case 1 had been diagnosed with iritis and vitreous opacity 5 years before. Topical betamethasone was followed by alleviation of iritis. Case 2 had noticed progressive visual impairment since 8 months before. Findings and Clinical Course：Best-corrected visual acuity was 1.0 and 0.7 respectively. Case 1 showed slight keratic precipitates and moderate vitreous opacity. She was treated by topical betamethasone under diagnosis of uveitis of unidentified origin. When seen after discontinuation of betamethasone for more than 2 weeks, the affected eye showed characteristic keratic precipitates, iris atrophy and iris nodules. She was diagnosed with Fuchs heterochromic iridocyclitis. Case 2 showed slight iris atrophy, mild posterior subcapsular cataract, and severe vitreous opacity in the affected eye. The serum and aqueous showed elevated level of antibody to rubella virus, leading to the diagnosis of Fuchs heterochromic iridocyclitis. Vitrectomy was followed by improvement of visual acuity to 1.0. Conclusion：These cases illustrate that vitreous opacity may be outstanding clinical manifestation of Fuchs heterochromic iridocyclitis.