一過性の浅前房と近視化をきたしたSLEの症例

Transient myopia and shallow anterior chamber in a case of systemic lupus erythematosus

19歳の全身性エリテマトーデス（SLE）の女性に，両眼の眼瞼浮腫と球結膜浮腫，5Dの近視，浅前房，30mmHgの高眼圧が生じた。超音波Aモード法で，浅前房と水晶体の前方移動が確認された。全身浮腫があり，内科でネフローゼ症候群によるSLEの急性増悪状態と診断され，プレドニゾロンの全身投与が開始された。内科の治療によく反応し，SLEは沈静し，全身浮腫は消失した。それとともに両眼の5Dの近視は正視となり、前房の深さと眼圧も正常化した。本例は全身浮腫のさいに毛様体の浮腫を生じ，それによって水晶体の前方移動と膨隆を生じ，一過性の浅前房と近視化を生じたと考えられた

A 19-year-old female developed butterfly -shaped erythema in the face, bilateral lid edema and chemosis. She was diagnosed as systemic lupus erythematosus (SLE) and was referred to us 10 days after onset of above features. She manifested myopia of 5 diopters, shallow anterior chamber and intraocular pressure of 30 mmHg in both eyes. She was during an active phase of SLE with secondary nephrotic syndrome and anasarca. Systemic treat-ment with massive dosis of prednisolone resulted in decreased activity of SLE, disappearance of myo-pia and shallow anterior chamber, and normaliza-tion of intraocular pressure. Ultrasonography dur-ing the acute phase showed shallow anterior cham-ber and foreward displacement of the lens. Edema of the ciliary body was apparently secondary to anasarca and was the cause of transient myopia and shallow anterior chamber.