原田病における網膜神経線維層厚の変化

Changes of retinal nerve fiber layer thickness in Vogt-Koyanagi-Harada disease

（17-P2-15）　走査レーザー眼底観察鏡（NFA）を用いて，原田病における網膜神経線維層厚（NFLT）と臨床所見との関連について検討した。対象は原田病の3例6眼で，全例にステロイド大量点滴療法（prednisolone換算で200mgより漸減）を施行した。NFLTは，全周平均値（μm）において6眼中6眼では有意差はなかったが，6眼中5眼で治療による漿液性網膜剥離の改善に伴ったNFLTの減少をみた。原田病では漿液性網膜剥離と乳頭周囲浮腫による網膜神経線維層の浮種を併発しており，病状の改善がNFLTの変化として反映されると考えられた。

We measured the thickness of the retinal nerve fiber layer in 6 eyes of 3 patients with active Vogt-Koyanagi-Harada disease. A nerve fiber analyzer was used in the measurement. All the patients were treated with tapering doses of systemic prednisolone starting at 200 mg per day. There were no changes in averaged nerve fiber layer thickness along the circle 1.5 disc diameters away from the center of the disc in the 6 eyes. Five eyes showed reduction in nerve fiber layer thickness in areas where serous retinal detachment was formerly present. The finding shows the presence of edema in retinal nerve fiber layer secondary to serous retinal detachment and peripapillary edema in this disease entity.