片眼病変の強い原田病の2例

Two cases of Vogt-Koyanagi-Harada disease with asymmetrical ocular manifestation

要約　目的：左右眼間に病変の差があるVogt・小柳・原田病2症例の報告。症例：症例はそれぞれ40歳と62歳の女性で，初診時の矯正視力はぞれぞれ右1.2と左0.1，右1.2と左0.5であった。後極部に漿液性網膜剝離があり，蛍光眼底造影と合わせてVogt・小柳・原田病と診断し，メチルプレドニゾロンを初回量500mgから漸減投与した。眼底病変は速やかに軽快したが，症例1での20か月後の左眼視力は0.7で，中心窩網膜厚が減少していた。症例2での18か月後の左眼視力は0.7で，網膜電図に軽度の反応低下があった。結論：片眼のみに病変が強いVogt・小柳・原田病では，視力改善が不十分である可能性がある。

Abstract.　Purpose：To report 2 cases of Vogt-Koyanagi-Harada（VKH）disease with asymmetry in ocular manifestations. Cases：Both were females aged 40 and 62 years respectively. Corrected visual acuity at the initial visit was 1.2 right and 0.1 left,and 1.2 right and 0.5 left respectively. Both cases showed serous retinal detachment in the posterior fundus. Findings by fluorescein angiography were compatible with the diagnosis of VKH disease. Both cases were treated by 500 mg methylprednisolone with tapering dosis. Both cases showed rapid response to the treatment. Visual acuity of the left eye in Case 1 was 0.7 20 months after treatment with decreased foveal thickness. Visual acuity of the left eye in Case 2 was 0.7 18 months after treatment. Electroretinogram showed decreased response. Conclusion：The present cases illustrate that visual outcome may be poor in severely affected eyes of VKH disease with asymmetrical ocular manifestation.