ほぼ同時期に発症したVogt-小柳-原田病の姉妹例

Vogt-Koyanagi-Harada disease in sisters occurred in a similar time period

要約　目的：ほぼ同時期に姉妹に発症したVogt-小柳-原田病（原田病）を経験したので報告する。

症例：症例1は42歳，女性。両眼の視力低下と頭痛を自覚し，3日後に近医を受診した。漿液性網膜剝離型の原田病と診断され，当科に受診となった。前医での初診時視力は右1.2（矯正不能），左0.5（矯正不能）であった。左眼底に漿液性網膜剝離を認めた。症例2は41歳，女性。症例1の妹である。症例1の受診から約2か月後，両眼の視力低下と頭痛を自覚し，5日後に近医を受診した。漿液性網膜剝離型の原田病の疑いで，当科に紹介となった。初診時の視力は右0.1（0.5），左0.3（0.5）で，両眼底に漿液性網膜剝離と脈絡膜肥厚を生じていた。入院のうえ，ステロイドパルス療法を行った。治療開始9か月後の現在まで再燃はないが，軽度の夕焼け状眼底を呈している。

結論：2症例は姉妹であり，漿液性網膜剝離型の原田病をほぼ同時期に発症した。兄弟，姉妹での原田病はきわめて稀であるが，発症の可能性を念頭に置く必要がある。

Abstract　Purpose：To report the cases of two sisters who developed Vogt-Koyanagi-Harada（VKH）disease almost simultaneously.

Case 1：A 42-year-old woman was referred to our emergency clinic because of headache and sudden loss of vision in both eyes. She was previously diagnosed with serous retinal detachment type of VKH disease and the best-corrected visual acuity（BCVA）was 1.2 in the right eye and 0.5 in the left eye at an eye clinic. Serous retinal detachment was present in her left eye.

Case 2：A 41-year-old woman was referred to us because of headache and sudden loss of vision in both eyes about 2 months after case 1's initial visit. She was the younger sister of Case 1. She had previously been suspected of having serous retinal detachment type of VKH disease at an eye clinic. The BCVA was 0.5 with a serous retinal detachments and thickened choroids in both eyes. She was treated with steroid pulse therapy. Although she has not experienced recurrence by 9 months after the initial visit, she has mild sunset glow fundus in both eyes.

Conclusion：These sisters with serous retinal detachment type of VKH disease occurred in within the same time period. Although this disease is quite rare in siblings, this possibility needs to be considered.