両眼性黄斑下脈絡膜新生血管を合併したEales病疑いの若年女子例

Bilateral subfoveal choroidal neovascularization in a girl of suspected Eales disease

要約　16歳女子が1か月前からの両眼視力障害で受診した。矯正視力は両眼とも0.1であり，右に-12D，左に-11Dの近視があった。両眼に中心窩下の脈絡膜新生血管があり，網膜下出血と漿液性網膜剝離を伴っていた。両眼の耳側周辺部に網膜静脈周囲炎，血管の白鞘化，無血管野があった。ツベルクリン反応が強陽性で，サルコイドーシスよりもむしろEales病を疑った。高度近視が中心窩下の脈絡膜新生血管の誘因であると推測した。フルオレセイン蛍光造影による脈絡膜新生血管の活動性低下がないため，初診から10週後に左眼，4か月後に右眼の新生血管除去術を行った。術後1年の現在，両眼とも0.15～0.2の視力を維持し，網膜静脈周囲炎の悪化はない。

Abstract.　A 16-year-old girl presented with decreased visual acuity in both eyes since one month before. Her corrected visual acuity was 0.1 in either eye. Myopia of-12 diopters was present in the right eye and that of-11 diopters in the left. Both eyes showed subfoveal choroidal neovascularization（CNV）associated with subretinal hemorrhage and serous retinal detachment. Both eyes showed retinal periphlebitis in the temporal periphery associated with vascular sheathing and nonperfusion. She was strongly positive for tuberculin test. We performed surgical excision of CNV after fluorescein angiography showed its persistant activity. she has been doing well until one year after surgery with no flare-up of retinal periphlebitis. We suspected Eales disease rather than ocular sarcoidosis. High myopia appeared to be the underlying cause of CNV.