経時的に眼血流測定を行ったサイトメガロウイルス網膜炎の1例

Repeated measurements of intraocular circulation in a case of cytomegalovirus retinitis

要約　目的：サイトメガロウイルス（CMV）網膜炎の経過をレーザースペックルフローグラフィ（LSFG）で追った1例を報告する。

症例と経過：67歳女性，糖尿病と間質性肺炎で加療中。初診時視力は右（1.2），左（0.5）で，左眼底後極部が中心の病変を認め，採血上CMVアンチゲネミア，前房水PCRでCMV陽性にて加療を開始した。出血斑は治療により軽快し，網膜滲出病巣は瘢痕化し，左視力は（1.2）へ回復した。経過中LSFGにてmean blur rate（MBR），波形解析項目のblowout time（BOT），blowout score（BOS）を測定した。左眼のMBR，BOT，BOSは顕著な変化を示した。

結論：CMV網膜炎の病状把握においてLSFGでの眼血流測定が有用な可能性がある。

Abstract　Purpose：To report a case of cytomegalovirus（CMV）retinitis followed up by repeated measurements of intraocular circulation.

Case：A 67-year-old female was referred to us for failing vision in the left eye since one month before. She had been diagnosed with diabetes mellitus 14 years before. She had developed interstitial pneumonia 18 months before.

Findings and Clinical Course：Corrected visual acuity was 1.0 right and 0.5 left. Both eyes showed exudative lesions in the periphery. Additional hematological findings led to the diagnosis of CMV retinitis. Systemic antiviral treatment, including ganciclovir, was followed by atrophy and scarring of fundus lesions. There has been no recurrence for 6 months until present. Laser speckle flowgraphy during the course of treatment showed increases in mean blur rate, blowout time and blowout score along with improvement in fundus findings in the left eye.

Conclusion：Laser speckle flowgraphy was useful in assessing the course of recovery of CMV retinitis.