ベーチェット病での眼底病変と前房蛋白濃度

Correlation between aqueous protein concentration and fundus lesion in Behçet's disease

　発症後5年以内の後部ぶどう膜炎型のベーチェット病30例での，眼底発作と前房フレア値の関係を，フレアセルメーターを用いて検討した。眼底発作とともに前房フレア値は上昇し，炎症が消退するにつれて減少したが，寛解期でも正常値より有意に増加しており，この傾向は数年間続いた。両眼例では，一眼の眼底発作時に発作眼だけでなく，他眼の前房フレア値も上昇することが多かった。他眼の前房フレア値が常に正常な片眼性ベーチェット病が4例あった。後部ぶどう膜炎での前房フレア値上昇の原因として，sub-clini—calな虹彩炎，血液房水柵の障害，硝子体腔からの蛋白の移動の可能性を考えた。

We evaluated 30 patients with Behçet's disease regarding the correlation between aqueous protein concentration and the state of the fundus lesions. We used a laser flare-cell meter in quantitating the aqueous protein concentration. The known history of eye involvement was 5 years maximum in all the cases.

Posterior uveitis was present in 40 eyes of 22 cases. An average of 3.5 fundus attacks developed during the 20 months of investigation. Aqueous protein level averaged 302.8 ± 144.2 mg/dl duringthe fundus attacks and 146.5 ± 64.7 mg/dl during the intervals between attacks. The latter value was still significantly higher than in normal eyes. The development of fundus attacks and increase of aqueous protein was synchronous. The elevated anterior protein concentration continued for one year or more after the last fundus attack. The observed increase in aqueous protein seemed to be due to subclinical iritis, disruption of blood-aque-ous barrier or transfer of protein from the vitreous cavity.