網膜血管周囲炎とぶどう膜炎を伴った樹枝状角膜潰瘍の1症例 新しい診断法と治療法

A case of dendritic corneal ulcer associated with retinal periphlebitis and uveitis. A new diagnostic method and treatment

　6歳女児の左眼に角膜樹枝状潰瘍が発生し，モノクロナール抗体を用いた螢光抗体法により単純ヘルペス1型（HSV1）による感染と迅速診断された．潰瘍はIDU治療で改善したが，発症より2週後HSVによると思われる網膜血管周囲炎が発生し，視力が低下した．これに対して，アシクロビルの内服を行い，網膜血管周囲炎は徐々に消失し，視力は回復した．アシクロビル投与中から直後にかけ血小板数の減少が見られたが，1カ月後には正常値に戻った．

A healthy 6-year-old girl presented with dendritic corneal ulcer associated with severe iritis in her left eye. Herpetic nature of the corneal lesion was promptly confirmed by direct immunofluorescent technique using monoclonal antibody to herpes simplex virus type 1. After the dendritic corneal ulcer subsided within a week folowing treatment with topical IDU, the affected eye developed vitreous opacity and periphlebitis 2 weeks after onset of the corneal ulcer, with visaul acuity of the left eye reduced to 0.06. The patient was then treated with systemic acyclovir at the daily dosis of 35 mg/kg for 10 days. The inflammatory fundus lesions started to subside 5 days after initiation of the treatment and completely disappeared in 2 weeks. The final visual acuity recovered to 1.2. No adverse reaction to acy-clovir was encountered except for transient decrease in the platelet count in the circulating blood.