脈絡膜腫瘍様症状を示した後部強膜炎の1例

Tumorous choroidal lesion masqueraded in a case of posterior scleritis

　強い硝子体混濁，滲出性網膜剥離，脈絡膜腫瘍性病変，黄斑浮腫など多彩な眼症状を呈した後部強膜炎の79歳女性例を報告した。主訴は両眼の充血，眼痛および視力低下であり，経過中周辺部ぶどう膜炎，悪性黒色腫，悪性リンパ腫などが疑われた。超音波像で眼球後壁の肥厚と平坦化および球後の浮腫，CT所見で眼球壁の肥厚と壁の不整が認められたことより，初診後9年目に後部強膜炎と診断した。後部強膜炎の診断には，超音波像やCT所見，特に超音波像が有用であった。

A 79-year-old female presented with recurrent episcleral injection and ocular pain since 18 months before. No fundus abnormality was present when initially seen by us. After cataract surgery in the right eye performed 5 years later, the operated eye showed diffuse retinal edema and exudation in the temporal periphery. The fundus lesion graduallyexacerbated during the following 3 years, resulting in exudative retinal and choroidal detachment with yellowish choroidal infiltrates.

The whole clinical course was suggestive of either peripheral uveitis, malignant melanoma or malignant lymphoma. We diagnosed the case as posterior scleritis because ultrasonography showed flattening of posterior eye wall with thickened posterior sclera and retrobulbar edema. Thickening of the sclera was also found by computed tomogra-phy with enhancement by injection of contrast media.