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要約 目的:両眼に虹彩ルベオーシスが出現し,ステロイドパルス療法を施行した原田病の症例の報告。症例:24歳男性が両眼の充血と霧視を主訴に近医を受診した。両眼の虹彩ルベオーシスを認めた。前眼部の炎症が強く,眼底所見の詳細は不明であった。原因不明のぶどう膜炎とされ,当院を紹介され受診した。所見:矯正視力は右0.3,左0.8で両眼の虹彩ルベオーシスを認め,眼底は夕焼け状眼底であった。髄液検査で細胞数の増加があり,感音性難聴も認めたため,原田病の診断でステロイドパルス療法を行った。ステロイドパルス療法後,矯正視力は改善し,虹彩ルベオーシスは著明に消退した。結論:前眼部の炎症が強いぶどう膜炎を診察する際には,原田病などの汎ぶどう膜炎の可能性を考慮し治療にあたる必要がある。
Abstract. Purpose:To report a case of Vogt-Koyanagi-Harada(VKH)disease with bilateral rubeosis iridis that received pulsed corticosteroid therapy. Case:A 24-year-old male was referred to us for inflammation in the anterior chamber with rubeosis in both eyes. He had had hyperemia and blurring since 2 months before. Findings:Corrected visual acuity was 0.3 right and 0.8 left. Pleocytosis was present in the cerebrospinal humor. He showed hearing difficulty. He was diagnosed with VKH disease and received pulsed corticosteroid therapy. Rubeosis iridis disappeared and visual acuity improved to 1.5 in either eye 8 months later. Conclusion:This case illustrates that VKH disease is a possibility when intense sign of anterior inflammation is present in uveitis.
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