発症から24年後に僚眼に再発した急性網膜壊死の1例

A case of unilateral acute retinal necrosis involving the fellow eye 24 years later

要約　目的：片眼発症から24年後に僚眼に再発した急性網膜壊死の報告。症例：38歳女性。15歳時に右急性網膜壊死と診断され硝子体手術を施行。24年後に左眼の霧視を訴え来院。視力は右（0.3）左（1.0）。左眼前房内炎症，乳頭腫脹，周辺部網膜の白濁，蛍光眼底造影検査で網膜血管からの漏出を認め，左眼前房水PCR検査により単純ヘルペスウイルスDNA7×10² copy/mlを認めたことから，急性網膜壊死再発と診断した。経過中左（0.3）まで低下したが，その後（0.7）へ回復した。結論：片眼の急性網膜壊死が20年以上経過した後の僚眼への発症例は少ない。長期間の経過観察が必要と考えた。

Abstract.　Purpose：To report a unilateral case of acute retinal necrosis（ARN）that involved the fellow eye after an interval of 24 years. Case：A 38-year-old female presented with blurring in the left eye since 2 weeks before. She had been diagnosed with ARN at the age of 15 and received vitreous surgery with photocoagulation. Findings：Corrected visual acuity was 0.3 right and 1.0 left. The left eye showed signs of anterior uveitis and opacity in the peripheral retina. Aqueous specimen from the left eye was positive for simple herpes virus, leading to the diagnosis of ARN. She has been doing well for 6 months until present with left visual acuity of 0.7. Conclusion：This case illustrates that initially unilateral ARN may develop in the follow eye after an interval of 24 years.