眼底出血を主徴としたサルコイドーシス症例

Fundus hemorrhage as the cardinal clinical manifestation in ocular sarcoidosis

　1960年から1990年までの30年間に188例の確定診断されたサルコイドーシス患者を経過観察した。188例を分類し，その眼症状には，（1）ぶどう膜炎を主徴とするタイプ，（2）血管病変を主徴とするタイプ，（3）（1）及び（2）の合併したタイプ，があった。そのうち血管病変を主徴とするグループのうち，眼底出血のみを主徴とした4症例を検討した。若年者で眼底出血を主徴とした全身合併症のない原因不明の疾患は，ぶどう膜炎，その他サルコイドーシス特有の病状が認められなくても、サルコイドーシスを鑑別診断に加える必要があると思われた。

I reviewed a consecutive series of 188 cases with confirmed sarcoidosis during the foregoing 30-year-period.

I suppose the outstanding ocular abnormalities could be classified into 3 categories.

Group Ⅰ Uveitis as a prominent feature

Group Ⅱ Vascular involvement as a promi-nent feature

Group Ⅲ Combined type of Group Ⅰ and Ⅱ

There were 4 relatively young adult patients with intraocular hemorrhages as a prominent clinical feature. Three cases manifested retinal hemorrhage and one case showed vitreal and retinal hemor-rhage.

In one case with retinal hemorrhage, the ocular sarcoidosis remained quiescent in the foregoing 7 years, during which neovascularizations developed from retinal arteries. Sarcoidosis may underlie in fundus hemorrhage in young adults even in the absence of systemic disorders or clinical symptoms typical for ocular sarcoidosis.