ステロイドパルス療法を行った地図状脈絡膜炎の1例

A case of geographic choroiditis treated by pulsed corticosteroid

要約　26歳男性が6日前からの左眼霧視と上方の視野欠損で受診した。矯正視力は右1.5，左1.2であった。左眼黄斑の下方に2～3乳頭径大の地図状萎縮があり，その上縁に浮腫があった。この萎縮巣はフルオレセイン蛍光造影で早期に低蛍光，晩期に色素漏出を伴う過蛍光を呈し，インドシアニングリーン蛍光造影で早期から晩期まで低蛍光であった。2週後に萎縮巣が中心窩に達し，視力が0.2に低下した。副腎皮質ステロイド薬のパルス療法で病変が寛解し，0.9の視力を現在までの1年間維持している。

Abstract.　A-26-year-old man presented with blurring of vision and upper visual field defect in his left eye since 6 days before. His corrected visual acuity was 1.2 in either eye. A geographic atrophy,3 disc diameters across,was present inferior to the fovea in his left eye. Fluorescein angiography showed hypofluorescence in the early phase and hyperfluorescence with dye leakage in the late phase. Indocyanine green angiography showed hypofluorescence throughout. The atrophic lesion almost reached the fovea 2 weeks later. The visual acuity decreased to 0.2. Pulsed corticosteroid therapy induced resolution of edema along the edge of atrophic lesion. He has been maintaining visual acuity of 0.9 left during the follow up for one year.