腎移植後に発症した中心性漿液性網脈絡膜症の4例

Four cases of central serous chorioretinopathy following renal transplantation

　腎移植後に発症した中心性漿液性網脈絡膜症の4例を経験した。4例とも腎移植後経過良好で，ステロイド剤と免疫抑制剤は維持量または漸減中であった。螢光眼底造影上は特記すべき所見はなかったが，HLAを検索したところ，A24，Cw1,DR4,DRw53が4例中4例にみられ，Cw3，DR5,DRw52,DQw3が4例中3例にみられた。病態生理上，中心性漿液性網脈絡膜症と類似の多発性後極部網膜色素上皮症が，腎移植後に発症した報告でもHLAの共通がみられており，Bw54を除くCw1,DR4が自験例とも一致していたため，両疾患の発症にHLAに示される免疫遺伝学的素因の関与が考えられた。

Four patients developed central serous chorio-retinopathy following uneventful renal transplan-tation. All the cases were under systemic immuno-supressant and corticosteroid either in maintaining or tapering dosis. Fluorescein angiography showed unique features as the eyes failed to show charac-teristic leakage pattern. All the four patients showed HLA for A24, Cw1, DR4, DRw53. Three patients showed Cw3, DR5, DRw52, DQw3. This feature was of interest as previous reports showed that cases with multifocal posterior pigment epithe-liopathy had similar HLA typing. These findings seemed to suggest that immunological factors were involved in the manifestation of central serous chorioretinopathy in the present series.