成人に発症した樹氷状網膜血管炎の1例

Frosted branch angiitis of the retina in an adult

　49歳の男性が2日前からの右眼霧視で受診した。35歳で多嚢胞腎を指摘され，1年前から慢性賢不全で透析を行っている。矯正視力は右0.1，左1.0であった。特徴的な眼底所見から右眼の樹氷状血管炎と診断し，ステロイド大量点滴療法を行った。開始から17日後に網膜血管の白鞘はほぼ消退し，36日後に右眼視力は1.0に回復し，以後1年間の経過は良好である。疾患群としての樹氷状血管炎では，網膜の閉塞性病変の有無が治療効果に関係すると推定された。

A 49-year-old male presented with blurring of vision in his right eye since 2 days before. He had been diagnosed with polycystic kidney at age 35. He had been under hemodialysis for chronic renal failure since one year before. His corrected visual acuity was 0.1 right and 1.0 left. The right eye showed typical features of frosted branch angiitis of the retina. Systemic treatment with massive corticosteroid was followed by disappear-ance of retinal sheathing 17 days later and by improved visual acuity of 1.0 right. He has been doing well during the following one year. It appeared that the absence of occlusive retinal lesion was a decisive factor for the observed beneficial therapeutic effect in this patient.