眼内液に帯状ヘルペスウイルス抗体価上昇を認めた桐沢型ぶどう膜炎の2例

Rise of antibody titer for varicella-zoster virus in the aqueous and vitreous in 2 cases with Kirisawa uveitis

　典型的桐沢型ぶどう膜炎2症例の房水と硝子体液のヘルペスウイルス抗体価（IgG）を検索し，2症例に共通して，帯状ヘルペスIgGの特異的上昇を認めた．特に症例2では，発病初期と末期の前房水でのペア抗体価が，256倍から1,024倍と4倍の上昇を示し，桐沢型ぶどう膜炎の病因として，帯状ヘルペス眼局所感染が強く示唆された．

The peculiar clinical entity, known in Japan as Kirisawa-type uveitis (1971) appears to be similar to, or identical with, acute retinal necrosis. We observed two cases of Kirisawa-type uveitis.

In the first case, a 30-year-old female, the dis-ease took a rapid progressive course in the right eye resulting in total retinal detachment within a month. The course in the left eye was less severe and included yellowish-white retinal opacifications in the peripheral retina. The aqueous and the vitreous were aspirated and analyzed as to virus antibody titers with immunofluorescence technique.Those for herpes simplex virus (HSV), varicella-zoster virus (V-ZV) and cytomegalovirus were tested. we detected an unusually high titer for V-ZV: 64 × in the aqeuous, 256 × in the vitreous, negative in the serum. The titer for V-ZV was still high in the vitreous (1280 ×) 9 months later.

Only the left eye was affected in the second case, a 57-year-old female. The clinical features included severe uveitis, vitreous opacity and retinal opacif-ications extending over the whole midperipheral retina. The antibody titers for V-ZV were 160 x in the serum and 256 x in the aqueous. Those for HSV were 1280 x in the serum and 32 x in the aqueous. Retinal detachment developed during the following 2 months. The titer for V-ZV had in-creased to 1024 both in the aqueous and the vit-reous. The HSV titer was the almost same at 56 x in both specimens.

Our findings seem to indicate that a varicella-zoster virus infection has been involved in the path-ogenesis of Kirisawa-type uveitis in these cases.