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要約 目的:両眼性の隔壁を伴う漿液性網膜剝離(SRD)を呈し,眼底自発蛍光(FAF)で特徴的な所見が得られた急性リンパ性白血病(ALL)を報告する。
症例:21歳の男性が右眼の視力低下で紹介受診した。15年前にALLを発症し,4年前に再発で化学療法を受けている。
所見と経過:視力は右0.5,左1.2で,光干渉断層計(OCT)で,Vogt-小柳-原田病(VKH)に類似した両眼眼底に隔壁を伴うSRDがあり,FAFでは高輝度と低輝度の入り混じったごま塩状陰影がみられ,OCTではSRD,脈絡膜の肥厚,網膜色素上皮の不均一な肥厚がみられた。ALLの再々発と診断され,化学療法施行後にこれらの所見は改善した。
結論:ALLに合併したVKH類似の両眼性のSRDの1例を経験した。FAFは本症とVKHを鑑別する一助となりうる。
Abstract Purpose:To report a case of acute lymphoid leukemia(ALL)with bilateral serous retinal detachment(SRD)and distinctive findings on fundus autofluorescence(FAF).
Case:A 21-year-old man was referred to us for visual disturbance in the right eye. He had received chemotherapy for ALL 15 years before. Recurrent ALL had occurred 4 years before.
Findings and Clinical course:The best corrected visual acuity was 0.5 OD and 1.2 OS. The bilateral SRD similar to Vogt-Koyanagi-Harada disease(VKH)found accompanied with granular hyperfluorescent and hypofluorescent dots on FAF. Optical coherence tomography(OCT)showed SRD, irregular thickening of retinal pigment epithelium, and thickened choroid. After he was diagnosed reccurent ALL, the chemotherapy for necurrail ALL, these findings had been improved.
Conclusion:We experienced bilateral SRD similar to VKH in eyes with ALL. FAF was helpful in differentiating SRD associated with ALL from VKH.
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