Acute syphilitic posterior placoid chorioretinitis（ASPPC）を呈した梅毒性ぶどう膜炎の3例

Three cases of acute syphilitic posterior placoid chorioretinitis（ASPPC）

要約　目的：Acute syphilitic posterior placoid chorioretinitis（ASPPC）を呈した梅毒性ぶどう膜炎の3症例の報告。

症例：症例はいずれも男性で，眼病変は片眼性で，年齢はそれぞれ47，48，58歳である。主訴はそれぞれ中心暗点，霧視，中心暗点とふらつきであった。

所見と経過：初診時の罹患眼の矯正視力は，それぞれ0.9，0.5，0.3であった。2例では患眼の後極部に境界鮮明な円板状病変，1例には滲出性網膜剝離と光干渉断層計で内部に隔壁があった。2例には駆梅療法を行い，円板状病変は急速に消退し，視力は1.2以上になった。1例にはステロイドパルス療法で網膜剝離は吸収され，円板状病変になった。駆梅療法で視力は0.7になった。

結論：梅毒の眼合併症として，片眼性の円板状病変が後極部に生じた。3症例ともASPPCであったと考えられ，駆梅療法が奏効した。

Abstract　Purpose：To report three cases of acute syphilitic posterior placoid chorioretinitis（ASPPC）.

Case：All were males and were unilaterally affected. They were aged 47, 48 and 58 years respectively. The chief complaint was central scotoma, blurring, and central scotoma with dizziness respectively.

Findings and Clinical Course：Best-corrected visual acuity of the affected eye was 0.9, 0.5 and 0.3 respectively. Two cases showed placoid lesion with well-defined margin in the posterior fundus. One case showed exudative retinal detachment with inner boundaries when observed by optical coherence tomography（OCT）. Systemic antibiotics for syphilis was effective in 2 cases, resulting in rapid resolution of placoid lesion with recovery of visual acuity to 1.2 or over. One case was initially treated by steroid pulse therapy, resulting in resolution of retinal detachment and in well-demarcated placoid lesion. Additional antisyphilitic therapy resulted in visual acuity of 0.7.

Conclusion：Three cases in the present series showed unilateral placoid lesion in the posterior fundus as common findings. All the 3 cases were interpreted as ASPPC and promptly responded to antisyphilitic therapy.