HTLV-Ⅰ関連ぶどう膜炎の臨床像

Clinical features of HTLV-Ⅰ associated uveitis

要約　目的：ヒトTリンパ球向性ウイルスⅠ型（HTLV-Ⅰ）の高浸淫地域である長崎での，HTLV-Ⅰ関連ぶどう膜（HAU）罹患者の臨床像の報告。対象：過去1年間に長崎大学病院を受診したHAU患者17名28眼を診療録に基づいて検索した。結果：年齢は49～79歳（平均62歳）であり，男性3例，女性14例で男女比は1：4.7であった。眼病変の発症年齢は35～76歳（平均57歳）であった。6例が片眼に発症し，11例が両眼に発症した。病型では中間部ぶどう膜炎が最も多かった。硝子体混濁が86％に，網膜血管炎が17％にあった。多くの症例ではステロイド治療に反応したが，2眼では硝子体手術を必要とした。甲状腺機能亢進症が29％にあり，2年間に46％の症例が再発した。結論：過去の報告と比べ，今回の症例群では女性の頻度が高かったが，その他の点では既報とほぼ一致した。

Abstract.　Background：Nagasaki Prefecture is known to be highly infested by human T-lymphotropic virus type Ⅰ（HTLV-Ⅰ）. Purpose：To report 28 eyes of 17 patients of HTLV-Ⅰ associated uveitis（HAU）seen in Nagasaki University Hospital during the past one-year period. Method：This retrospective study was based on clinical records. Results：The present series comprised 3 males and 14 females, resulting in male-female ratio of 1：4.7. The age ranged from 49 to 79 years, average 62 years. Ocular manifestations started between 35 to 76 years, average 57 years. Six cases were unilaterally and 11 cases were bilaterally affected. Intermediate uveitis was the most frequent subtype of uveitis. Vitreous opacity was present in 86％ and retinal vasculitis in 17％ of cases. Ocular lesions responded well to topical or systemic corticosteroid. Vitreous surgery had to be performed in 2 eyes. Hyperthyroidism was present in 29％ of cases. Ocular lesions recurred in 46％ of cases during 2 years of observation. Conclusion：The present study of HAU is characterized by a high incidence of female over male patients. Other findings are generally in accordance with those in literature.