風疹によると思われる急性脈絡網膜症の1例

Acute rubella chorioretinopathy

　風疹の稀な合併症と思われる急性脈絡網膜症の1例を報告する．本症例では左眼に漿液性網膜剥離を認め，螢光造影において，早期像では多発性螢光漏出点と脈絡膜毛細血管板の充盈遅延が，後期像では螢光漏出部位における色素の貯溜充盈遅延がみられた部位での軽度の過螢光がみられた．また眼症状の直後に風疹の発症がみられ，風疹抗体価の有意な上昇を認めた．これより本症例ではウイルスによるRPEへの一次的な障害に加え，脈絡膜循環障害が存在すると考えられた．眼症はbetamethasone投与に反応し，3カ月後には右1.2，左1.0の視力が得られ，従来述べられてきた風疹網膜症と同じく，良好な視力予後を呈することが示された．

A 11-year-old female child presented with de-creased vision in her left eye since the day before. Visual acuity was 0.8 right and 0.3 left. The ante-rior segment was unremarkable.we observed an oval-shaped serous detachment around the macula in the left eye. No vitreous opacity was present. Fluorescein angiography showed numerous points of leakage and later dye pooling in the area of serous detachment.There were areas of pro-nounced choroidal filling delay.

The finding was suggestive of Harada's disease.Systemic signs of rubella, including fever, head-ache, skin eruptions and lymphnode swelling, became manifest 3 days after eye involvement. The serum titer for rubella rose from 1 : 204 to 1 : 3264 within 15 days. Serous detachment steadily regres-sed while the patient was placed under systemic therapy with betamethasone for 4 weeks. Visual acuity returned to normal level 3 months later. We diagnosed the case as presumed acute rubella retinopathy. As a unique feature of the present case, circulatory disturbances in the choriocapillar-is seemed to be present in addition to lesions in the retinal pigment epithelium.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(12) : 1313-1317, 1988