大動脈炎症候群を伴うホジキン病にみられた網膜血管炎

Retinal vasculitis developed in a case with Hodgkin disease and aortitis syndrome

　大動脈炎症候群を伴うホジキン病にみられた網膜血管炎の1例について報告した．症例は17歳男子で，1982年9月ホジキン病と診断され化学療法をうけていた．1986年5月両眼の視力低下を訴え名古屋大学附属病院分院眼科を受診した．この時，右眼底に白鞘化した血管および網脈絡膜萎縮巣を多数認め，網膜血管炎と診断された．その原因として各種ウイルスにつき諸検査を行ったがいずれも陰性の結果であった．初診後1年余にわたって経過を追っているが著明な変化は認められず，慢性の経過をとっているウイルス性網膜炎の可能性を念頭におき経過観察中である．

A 17-year-old male was diagnosed as Hodgkin disease after surgery for mediastinal tumor 4 years before. He has been under chemotherapy since. Extensive attenuation of femoral arteries were detected 3 years before and led to the diagnosis of aortitis syndrome. He was referred to us on account of gradually failing visual acuity.

The fundus picture was dominated by pigment-laden, perivascular sheathing, associated by dis-seminated, small chorioretinal atrophic patches. Both eyes were involved. Fluorescein angiography showed absence of dye leakage from the sheathed vessels. We suspected opportunistic viral infection in the pathogenesis of the fundus lesions, although peripheral blood tests were negative for herpes simplex virus, herpes zoster virus, or cytomegalovirus. The fundus findings are almost stationary during the consequent one-year follow -up period.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(7) : 889-892, 1988