猫ひっかき病が原因となった視神経網膜炎の2例

Two cases of neuroretinitis as manifestation of cat scratch disease

要約　目的：異なる方法で治療した猫ひっかき病に伴う視神経網膜炎の2例の報告。

症例：それぞれ34歳と53歳の女性で，いずれも片眼に発症した。2例ともに猫の飼育歴があり，数日前に発熱があった。患眼の矯正視力は，それぞれ0.09と0.02で，乳頭浮腫，乳頭黄斑間の網膜下液の貯留，星芒状白斑があった。血清学的にBartonella henselae抗体が陽性で，猫ひっかき病と診断した。1例には副腎皮質ステロイドの全身投与を行い，他の1例は無治療とした。それぞれ3か月後と14か月後に，1.0と0.8の最終視力を得た。

結論：猫ひっかき病による眼病変への治療法は確立していないので，病状に応じた加療を選択するべきである。

Abstract　Purpose：To report two cases of neuroretinitis as manifestation of cat scratch disease.

Cases：Both were females aged 34 and 53 years respectively. Both were unilaterally affected. Both were keeping domestic cats and had fever a few days before. Corrected visual acuity was 0.09 and 0.02 respectively. The affected eyes showed optic disc edema, subretinal fluid between the disc and macula, and star figure in the macula. Both cases were serologically positive for Bartonella henselae and were diagnosed with cat scratch disease. One case was treated by systemic corticosteroid and the other received no medication. Final visual acuity was 1.0 and 0.8 respectively.

Conclusion：There is no standard treatment for ocular involvement by cat scratch disease. Therapeutic approach is to be selected for each patient according to the clinical features.