続発閉塞隅角緑内障を契機に診断に至った再発性多発軟骨炎の1例

A case of relapsing polychondritis diagnosed by secondary angle closure glaucoma

要約　目的：続発閉塞隅角緑内障を契機に再発性多発軟骨炎の診断に至った1例を経験したので報告する。

症例：51歳，男性。右眼痛を主訴に前医を受診し，急性緑内障発作の診断で加古川市中央市民病院眼科に紹介となり，水晶体再建術を施行した。術中に破囊し，硝子体手術を追加した際に脈絡膜剝離が認められたが，前眼部光干渉断層計で術前より毛様体剝離があったことが確認された。術1週間後に僚眼に強膜炎が出現し，術前より両側の耳介が腫脹していたことから，再発性多発軟骨炎の診断に至った。

考察：再発性多発軟骨炎の眼症状として，強膜炎やぶどう膜炎とともに閉塞隅角症も念頭に置く必要がある。

Abstract　Purpose：To report a case of relapsing polychondritis diagnosed by secondary angle closure glaucoma.

Case：A 51-year-old patient with ocular pain in his right eye presented to an ophthalmic clinic. He was diagnosed with angle closure glaucoma and referred to our hospital. During phacoemulsification-aspiration procedure for angle closure glaucoma, his posterior capsule was ruptured and we noticed choroidal detachment at the time of ports setting. Anterior segment optical coherence tomography showed supraciliary fluid preoperatively. In addition to the presence of redness and swelling of both auricles before the first ocular onset, scleritis appeared in both eyes one week after the surgery. Due to these clinical findings, he was diagnosed with relapsing polychondritis.

Conclusion：In cases of relapsing polychondritis, angle closure glaucoma can be in initial ophthalmic symptom.