皮疹のない眼部帯状庖疹

Herpes zoster ophthalmicus without skin eruptions

　緒言　眼部帯状庖疹は三叉神経領域に典型的な皮疹を認めれば診断は比較的容易であるが，一方，皮疹を伴わない眼部帯状庖疹（zoster sine herpete）も存在している。本疾患の原因ウイルス（varicella zoster　virus：VZV）の分離は非常に困難であるため，現時点では本症の診断はウイルスの血清抗体価に依存するところが極めて大きい。今回筆者らは，VZVの血清抗体価と臨床症状から皮疹なしの眼部帯状抱疹を疑った症例について，症例数，性別，平均年齢，臨床症状などを，皮疹を伴う眼部帯状庖疹の症例と比較検討したので報告する。

We reviewed 29 cases of unilateral ophthalmic herpes zoster with or without skin eruptions during the foregoing 28 months. The former comprised 11 cases without and 18 with skin eruptions. The ocular manifestations in the former 11 cases includ-ed keratitis 7 eyes, conjunctivitis 9, scleritis 5, iridocyclitis 8, retinochoroiditis 3. Ocular manifes-tations in the latter 18 included keratitis 17 eyes, conjunctivitis 16, iridocyclitis 11, retinochoroiditis1. Serum antibody titers, including complement fixation tests, were positive for 2 or more items in 28% of cases in the former and in 38% in the latter. There was a tendency for cases without skin erup-tions to manifest retinochoroiditis and for those with skin involvement to manifest keratitis at higher frequencies.