原田病に対する赤外蛍光眼底造影像と治療の評価

Indocyanine green angiographic features and therapeutic outcome in Harada disease

要約　両眼発症の原田病19例の赤外蛍光造影所見と治療経過を検索した。赤外蛍光造影では，脈絡膜中大血管の不明瞭化と数の減少，低蛍光斑の散在，脈絡膜血管透過性亢進による過蛍光などが特徴的であった。これらの所見は，フルオレセイン蛍光造影では診断が困難な症例でもみられ，診断に有用であった。治療によって漿液性網膜剝離が消失し，フルオレセイン蛍光造影所見がほぼ正常化している時期でも，赤外蛍光造影では脈絡膜循環不全を示す所見が得られた。赤外蛍光造影による所見をもとに治療を行った症例は良好な経過を示した。原田病の詳細な病態の把握，診断，治療の評価に赤外蛍光造影が有用な補助手段であると結論される。

Abstract.　We reviewed 19 cases of bilateral Harada disease. We paid particular attention to findings by indocyanine green（ICG）angiography and to the clinical course of the disease. ICG angiography showed,as characteristic features,indistinct major choroidal vessels,hypofluorescent patches and hyperfluorescence secondary to hyperpermeability of choroidal vessels. These features were present even in cases showing unconventional findings by fluorescein angiography.ICG angiography showed insufficient choroidal circulation after resolution of serous retinal detachment with normal findings by fluorescein angiography. All the cases resulted in favorable outcome when treatment was guided by ICG angiography. We conclude that ICG angiography is a useful ancillary method in the diagnosis,treatment and evaluation of pathological features in Harada disease.