IRVAN症候群の1例

A case of idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN syndrome)

　36歳女性が，1年前からの右眼飛蚊症，2か月前からの右眼視力低下と変視症で受診した。矯正視力は右0.5，左1.5であった。両眼に乳頭周囲の網膜深層に硬性白斑が多数あり，後極部の動脈は分岐部で動脈瘤様に拡張し，周辺部の網膜血管は閉塞して広範囲の無血管領域があった。両眼に乳頭上新生血管があり，右眼には増殖網膜症と硝子体出血があった。特発性網膜血管炎，網膜動脈瘤，神経網膜炎（IRVAN症候群）と診断した。ステロイド薬の全身投与，両眼網膜周辺部への汎網膜光凝固，右硝子体手術で治癒した。治療開始から20か月後の現在まで経過は良好であり，矯正視力として右1.0，左1.5を維持している。

A 36-year-old female presented with flying flies since one year before. She had also visual disturbance and metamorphopsia for 2 months in her right eye. Her corrected visual acuity was 0.5 right and 1.5 left. Both eyes showed disc neovascularization and numerous hard exudates around the optic disc. Retinal arteries showed aneurysmal dilatations at the sites of branching. Extensive nonperfused area was present in the peripheral retina.Additionally, the right eye showed proliferative retinopathy and vitreous hemorrhage. These findings led to the diagnosis of IRVAN syndrome, comprising idiopathic retinal vasculitis, aneurysms and neuroretinitis. Cure was obtained following oral prednisolone, panretinal photocoagulation to the nonperfused retinal area in both eyes,and vitrectomy in the right eye. She has been doing well during 20 months after treatment with visual acuity of 1.0 right and 1.5 left.