12年後に再発したVogt—小柳—原田病の1例

Recurrence of Vogt-Koyanagi-Harada disease twelve years after the initial episode

　初発から12年の経過を経て再発した原田病の1症例を経験した。患者は初発時25歳の女性で，両眼性の虹彩毛様体炎と漿液性網膜剥離を有したが，ステロイド大量療法により合併症を残さず治癒し，軽度の夕焼け状眼底を呈した。その後，炎症を認めなかったが，37歳時に再発した。再発時には，右眼のみに漿液性網膜剥離を，両眼に軽度の虹彩毛様体炎と螢光眼底検査における脈絡膜からの螢光漏出が認められ，ステロイド大量療法により治癒した。原田病発症時にステロイド大量療法によって遷延化することなく，また，重篤な合併症を残さず鎮静化した症例においても，漿液性網膜剥離再発の可能性が考えられる。

Widespread use of high-dose corticosteroid has changed the clinical feature of VKH syndrome.Most cases have been cured without lasting complications or sunset glow fundus. We observed a patient who developed recurrence of serous retinal detachment 12 years after the initial episode. A 25-year-old female with VKH syndrome was successfully treated with high-dose corticosteroid. She regained normal vision with mild sunset glow fundus. No evidence of recurrence had been noted since. At the age of 37, she developed blurred vision in her right eye. She showed mild iridocyclitis in both eyes and serous retinal detachment in the right. Fluorescein angiography showed typical multipoint dye leakage from the choroid. Rapid resolution was achieved with high-dose corticosteroid. This case suggests that serous retinal detach-ment may recur in VKH syndrome even after apparent longterm cure. Presence of mild sunset glow after initial treatment seemed to necessitate close observation for recurrence.