両眼の全周辺部網膜血管閉塞を伴った網膜血管炎の1例

A case of retinal vasculitis with bilateral widespred retinal nonperfusion

　両眼に全周性の広範な無血管野を伴った原因不明の網膜動静脈炎の1例を報告した。

　症例は28歳の女性。両眼の硝子体に軽度の白色点状浮遊物を，右眼には軽度の硝子体出血を認めた。両眼底には赤道部より周辺部で網膜血管が認められず，動脈の白鞘化や，螢光眼底検査で動静脈と毛細血管からの螢光色素の漏出が認められた。

　ステロイド剤，血管強化剤等の投与やアルゴンレーザー光凝固術に反応せず，無血管野は進行し，2ヵ月後には両眼乳頭から新生血管膜が生じ，硝子体出血を繰り返して，視力は著しく低下した。

　最近，本症例と類似の症例が報告されているが，イールズ病とはやや異なると思われた。

A 28-year-old woman presented with myode-sposia in the right eye as chief complaint. Inflam-matory signs were present in the vitreous in both eyes but not in the anterior chamber. Minimal vitreous hemorrhage was present in the right eye. Fluorescein angiography revealed the presence of retinal nonperfusion extending over the whole peripheral fundus. Extravasation of dye was seen from retinal arteries, veins and capillaries in both eyes. Ophthalmological and systemic examinations failed to elucidate the pathogenesis of the condi-tion.

Systemic corticosteroid and laser photocoagula-tion did not prevent further spread of the avascular area. Neovascular membrane started to develop from the optic disc in both eyes 2 months later. The visual acuity was reduced to less than 0.01 in both eyes because of recurrent vitreous hemorrhage 10 months later.

Reports on 6 similar cases appeared in recent literature. We thought that the present and the reported case are identical and represent a modified form of Eales' disease.