ステロイド懸濁液の鼻腔粘膜内注射直後に片側の網膜および脈絡膜血管塞栓がみられた1症例

Retinal and choroidal embolism immediately after ipsilateral intranasal injection of corticosteroid suspension

（P−1-125）　49歳女性が嗅覚障害の治療として，酢酸メチルプレドニゾロン懸濁液0.5mlの左鼻腔内注射を受けた。その直後から左眼の暗黒感と複視が生じ，その10分後に眼科を受診した。左眼視力は1.2で，眼底の網膜血管末梢に多数の塞栓があり，周囲に軟性白斑があった。橙色の点状病巣が眼底後極部の深層にあり，脈絡膜血管の塞栓と診断した。1週間後，これら眼底病変は特発性に消失し，他の異常も生じなかった。鼻腔内に注射したステロイド懸濁液が血管に入り，網脈絡膜血管の塞栓を起こしたものと解釈された。

A 49-year-old female received an injection of 0.5 ml of suspension of methylprednisolone into the left nasal septum for treatment of anosmia. She noted immediately black-out in her left eye and diplopia. She was seen 10 minutes after the incident. Her left visual acuity was 1.2. Funduscopy showed numerous emboli in the peripheral retina with soft exdates in the affected eye. Orange spots were scattered deep in the posterior fundus and were interpreted as embolic foci of choroidal vessels. These fundus lesions spontaneously disappeared one week later with no serious consequences. It appeared that intranasally injected corticosteroid suspension inadvertently entered the blood vessels and induced embolism of retinal and choroidal vessels.