片眼にのみ検眼鏡的に眼底所見を有した原田病の1例

A case of Harada disease with unilateral ophthalmoscopic involvement

（P3-1-23）　17歳女性が2日前からの左眼視力障害で受診した。矯正視力は右1.2，左0.5であり，前房に炎症所見はなかった。左眼のみに黄斑浮腫があり，フルオレセイン螢光眼底造影で色素の漏出と網膜下の貯留があり，原田病と診断した。右眼底は検眼鏡的に正常所見を呈した。インドシアニングリーン螢光造影で，両眼の脈絡膜血管の透過性異常があった。ステロイドの全身投与を3週後に開始したが，全経過を通じて右眼眼底には検眼鏡的な異常はなかった。本症例は，原田病には臨床的には片眼のみの罹患がありうるが，両眼に網脈絡膜炎が潜在していることを示している。

A 17-year-old female presented with blurring of vision in her left eye since two days before. Her corrected visual acuity was 1.2 right and 0.5 left. No inflammatory signs were present in the anterior chamber in either eye.Macular edema was present in the left eye. Fluorescein angiography showed multiple dye leakage with pooling beneath thesensory retina, leading to the diagnosis of Harada disease. The right eye was ophthalmoscopically normal. Indocyanine green angiography showed hyperpermeability of choroidal vessels in both eyes. Systemic corticosteroid therapy was started 3 weeks after her initial visit. The right fundus remained apparently normal throughout the course of the disease. This case illustrates that only one eye may be apparently affected in Harada disease in spite of the presence of retinochoroiditis in both eyes.