健康な高齢者にみられた進行性網膜外層壊死類似の眼底病変を伴った汎ぶどう膜炎

摘要

Purpose : To report a case of advanced age with panuveitis and findings simulating progressive outer retinal necrosis. Case : A 79-year-old male developed iridocyclitis in both eyes. He was referred to us 2 weeks later for suspected acute retinal necrosis. He had no history of herpes zoster. Findings : His corrected visual acuity was 0.4 right and counting fingers left. The left eye showed dense vitreous opacity and elevated exudative retinal lesion. No viral nucleic acid of herpes group was detected in the vitreous specimen. Increase of exudation along retinal vessels was suggestive of cytomegalovirus (CMV) infection. Intraocular lesions gradually subsided after peroral anti-CMV drug and prednisolone but recurred after decrease or withdrawal of medication. Final regression occurred one year after onset with visual acuity of 0.9 right and 0.1 left. There had been no occlusion of retinal vessels throughout the course. Conclusion : CMV may have been etiologically involved in the present case.