血栓溶解剤pro-urokinaseが奏功した滲出期網膜中心静脈閉塞症の1例

Systemic pro-urokinase was effective in a case of central retinal vein occlusion

　Pro-urokinaseは一本鎖型の不活性ウロキナーゼ前駆体で，ウロキナーゼに比べ，著明な血栓特異性を示す。筆者らは網膜中心静脈閉塞症に対して，新しい血栓溶解剤であるpro-urokinaseを投与する機会を得たので報告する。症例は，43歳男性であり，右眼眼底にびまん性の網膜出血と軟性白斑を生じており，当科初診時には，すでに一般の線溶療法の適応をすぎた後期滲出期の網膜静脈閉塞症であったが，同患者の強い要請もあってpro-urokinaseを投与した結果，視力の改善，出血，軟性白斑の吸収が得られ，長期にわたり経過良好であった。

Pro-urokinase is a single-chain urokinase type plasminogen activator. It is characterized by a higher fibrin affinity as compared with urokinase. We used this preparation to a case of central retinal vein occlusion with beneficial effects. A 43-year-old male presented with diffuse retinal hemorrhage and soft exudates in the right eye of 7 weeks' duration. Prior systemic urokinase and corticosteroids before visiting us were futile. We treated this patient by intravenous pro-urokinase at the daily dosis of 15,000 units for 5 consecutive days. The fundus lesions showed remarkable regression. Visual acuity improved from the initial value of 0.04 to 0.3 at the end of 4 weeks. The eye has remained in stable condition without residual nonperfusion area for the ensuing 2 years until present.