自己免疫網膜症が疑われた2例

Two suspected cases of autoimmune retinopathy

目的：腫瘍がなく，癌関連網膜症（cancer-associated retinopathy：CAR）に類似した自己免疫網膜症2症例の報告。症例：年齢が41歳と48歳の女性で，いずれも視力障害を主訴として受診した。矯正視力は，1例は右眼0.3と左眼指数弁，他の1例は右眼0.01と左眼0.07で，3年後に右眼指数弁，左眼0.02になった。1例では動脈の狭細化が高度で，びまん性の網膜色素上皮の萎縮があった。他の1例には動脈の狭細化があり，蛍光眼底造影所見はほぼ正常であった。両症例とも，全身検査で腫瘍はなく，CAR自己抗体は陰性であった。結論：腫瘍と自己抗体の存在が証明できなかったが，2症例ともその経過と眼底所見から，自己免疫網膜症が強く疑われる。

Purpose：To report two cases suspected of autoimmune retinopathy resembling cancer-associated retinopathy. Cases：This study involved two females aged 41 and 48 years. Both had impaired visual acuity as chief complaint. Corrected visual acuity was 0.3 right and counting fingers in the first case. It was 0.01 right and 0.07 left in the second case at her initial visit and counting fingers right and 0.02 left 3 years later. The first case showed attenuated retinal vessels and diffuse atrophy of retinal pigment epithelium. The second case showed extremely attenutated retinal vessels. Fluorescein angiography showed almost normal findings. Malignancy was ruled out in both cases by systemic examinations. Both were negative for CAR antibody. Conclusion：There is a high possibility of autoimmune retinopathy in both cases in spite of absence of tumor or CAR autoantibody.