原田病類似の漿液性網膜剥離を合併した樹氷状血管炎の成人例

A case of frosted-branch retinal angitis with bilateral serous retinal detachment

　原田病類似の両眼性の漿液性網膜剥離をきたし，網膜静脈の白鞘化を呈したいわゆる樹氷状血管炎の1例を報告した。症例は24歳女性で，初診時視力は右0.02，左0.1。両眼に視神経乳頭の発赤，多発性の漿液性網膜剥離，広範な静脈の白鞘化をみた。螢光眼底撮影では両眼とも脈絡膜から網膜下への螢光漏出，および白鞘化した静脈と乳頭からの漏出が認められた。4か月後に夕焼け状眼底は示さず，後極部から中間周辺部にかけて散在性の網膜色素上皮の小斑状萎縮巣が認められ，螢光眼底撮影ではそれに一致した過螢光がみられた。本症例は原田病に類似する所見を伴い樹氷状血管炎を呈した稀な症例と考えられた。

A 24-year-old woman presented with blurred vision and metamorphopsia in both eyes. The cor-rected visual acuity was 0.02 in the right eye and 0.1 in the left. Funduscopy showed hyperemia of the optic disc, multiple serous retinal detachment and extensive sheathing of retinal veins in both eyes. Fluorescein angiography showed dye leakage from the choroid to the subretinal space andextravasation from sheathed veins and the disc. Mild lymphocytosis was present in the cere-brospinal fluid.

Serous retinal detachment and venous sheathing resolved after systemic corticosteroid. Visual acu-ity improved to 1.0 each. Small patches of atrophic pigment epithelium became manifest in the poste-rior and midperipheral retina 4 months later. Find-ings of “sunset glow” as in Harada's disease was consistently absent.