Vogt-小柳-原田病の病型と予後の検討

Outcome of Vogt-Koyanagi-Harada disease as related to clinical types

要約　目的：Vogt-小柳-原田病（原田病）の病型別の統計報告。対象と方法：過去3年間に初診として受診した原田病24例を対象とした。男性15例，女性9例で，年齢は26～69歳，平均45歳である。9か月以上の経過を追い，病型，夕焼け状眼底の程度，視機能を検討した。結果：後極部剝離型は16例，乳頭周囲浮腫型は8例にあり，平均年齢はそれぞれ37歳と62歳で，後者が有意に高齢であった。早期治癒は15例，遷延例が9例で，平均年齢はそれぞれ40歳と54歳で，後者が有意に高齢であった。夕焼け状眼底が中等度以上の症例では，58％が遷延化し，これが軽度な症例よりも脈絡膜が有意に菲薄化し（p＝0.01），青色錐体感度視野が有意に低かった（p＝0.006）。結論：炎症が遷延し，夕焼け状眼底の程度が強い原田病では，視機能障害が強い。

Abstract.　Purpose：To report the outcome of Vogt-Koyanagi-Harada（VKH）disease as related to the clinical types. Cases and Method：This retrospective study was made on 24 cases of VKH disease seen by us in the past 3 years. The series comprised 15 males and 9 females. The age ranged from 26 to 69 years, average 45 years. They were followed up for 9 months or longer and were evaluated regarding clinical type, degree of sunset-glow fundus, and visual function. Results：Retinal detachment in the posterior fundus was present in 16 cases. Eight cases showed peripapillary edema. The age averaged 37 and 62 years respectively. The difference was significant. Clinical manifestations resolved early in 15 cases and protracted in 9 cases. The age averaged 40 and 54 years respectively. The difference was significant. Protracted course resulted in 58％ of cases with sunset-glow fundus. Cases with more advanced sunset-glow fundus showed more thinning of the choroid（p＝0.01）and lower sensitivity for short-wavelength perimetry（p＝0.006）than the rest. Conclusion：Visual function is more affected in cases of VKH disease that show protracted course or more manifest sunset-glow fundus.