高齢男性に発症した増殖性サルコイドーシスぶどう膜炎の2症例

Proliferative sarcoid retinopathy in two elderly males

　78歳と67歳の男性の両眼に霧視が生じ，ぶどう膜炎とサルコイドーシスと診断した。ステロイド薬の全身投与などを行った。1例では再燃を繰り返し，硝子体混濁と新生血管が生じた。両眼に網膜光凝固を行ったのち，硝子体混濁が軽減し，血管新生は消失した。他の1例ではステロイド薬の漸減時に再燃し，両眼に硝子体混濁，顕著な持続性の網膜静脈周囲炎，新生血管が起こった。左眼に硝子体出血が生じ，硝子体手術を行った。術後硝子体混濁は消失し，網膜静脈周囲炎は軽快した。手術を行わない右眼には網膜静脈周囲炎と硝子体混濁が残存している。光凝固または硝子体手術が増殖性サルコイドーシス網膜症に有効であることを示す症例である。

Two males, aged 78 and 67 years each, developed bilateral blurring of vision. Both were diagnosed with retinal periphlebitis, uveitis and sarcoidosis. They were treated with systemic corticosteroid and others.The first case developed vitreous opacity and retinal neovascularization. Retinal photocoagulation induced regression of neovascularization and vitreous opacity. In the second case, tapering of corticosteroid resulted in recurrence in both eyes with vitreous opacity, severe retinal periphlebitis and neovascularization. Vitreous hemorrhage developed in his left eye. Vitrectomy induced prompt regression of vitreous opacity and retinal periphlebitis. Vitreous opacity and retinal periphlebitis persisted in his right eye which did not receive vitreous surgery. These cases illustrate that photocoagulation and vitrectomy may be effective for proliferative sarcoid retinopathy.