脈絡膜結節を呈したサルコイドーシスの2例

Choroidal granuloma in two cases of sarcoidosis

要約　眼サルコイドーシスの2例に脈絡膜肉芽腫が生じた。1例は32歳女性。汎ぶどう膜炎が両眼にあった。プレドニゾロン内服を漸減中に，左眼黄斑部近傍に漿液性網膜剝離を伴う2乳頭径大の網膜下隆起性病変が生じた。他の1例は26歳男性。右眼黄斑部に漿液性網膜剝離を伴う3乳頭径大の網膜下隆起性病変が初診時にあり，その後サルコイドーシスと診断された。両症例ともプレドニゾロン内服が奏効したが，男性例では投薬の漸減中に再発し，病巣が拡大した。両例とも最終的に肉芽腫は瘢痕化した。サルコイドーシスによる脈絡膜肉芽腫に対する副腎皮質ステロイド薬投与では，十分な初期量と経過に応じた漸減が必要である。

Abstract.　Choroidal granuloma developed in two cases of sarcoidosis. A 32-year-old woman had bilateral panuveitis secondary to sarcoidosis. During treatment by tapering dosis of oral prednisolone,a subretinal granulomatous mass appeared near the macula in her left eye. The mass was 2 disc diameters（DD）in size and was accompanied by serous retinal detachment. Another 26-year-old man had a subretinal granulomatous mass in the macular area in his right eye. The mass was 3 DD in size and was accompanied by serous retinal detachment. He was later diagnosed with sarcoidosis. The granulomatous lesion responded well to oral prednisolone. There was a recurrence and enlargement of the lesion during tapering of prednisolone in the second case. The granuloma turned into atrophic scarring in both cases. The findings show that choroidal granuloma in sarcoidosis need oral corticosteroid in sufficient initial dosis with gradual tapering.