急性後部多発性斑状網膜色素上皮症様所見を呈した原田病の1例

A case of Vogt-Koyanagi-Harada disease simulating acute posterior multifocal placoid pigment epitheliopathy

　51歳女性が，1か月前からの右眼の色視症で受診した。矯正視力は左右とも1.5であった。前眼部と硝子体に炎症所見はなく，乳頭周囲網膜浮腫と後極部に黄白色斑が多発する所見が両眼にあった。フルオレセイン蛍光眼底造影では，乳頭からの蛍光漏出と，後極部の黄白色斑部位に一致する低蛍光があった。初診の20日後に虹彩毛様体炎と隅角結節が両眼に出現し，原田病と診断した。プレドニゾロンの全身投与で炎症は消退した。原田病では急性後部多発性斑状網膜色素上皮症に類似する眼底病変が生じうることを示す症例である。

A 51-year-old female presented with chloropsia in her right eye since one month before. Her corrected visual acuity was 1.5 in either eye. No inflammatory findings were present in the anterior segment or the vitreous. Both eyes showed peripapillary retinal edema and multiple yellow-white placoid patches in the posterior fundus area. Fluorescein angiography showed dye leakage from the optic disc and hypofluorescence corresponding to placoid patches. Signs of iridocyclitis and nodules in the chamber angle appeared 20 days later in both eyes, leading to the di-agnosis of Vogt-Koyanagi-Harada (VKH) disease. Sings of inflammation subsided following systemic prednisolone. This case illustrates that VKH disease may simulate acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in its early stage.