Palisades of Vogtの消失する角膜疾患

Disappearance of palisades of Vogt in ocular surface diseases

　角膜輪部に存在する皺襞palisades ofVogt （POV）が完全に消失している角膜疾患を臨床的に検討した．今回検討した疾患のなかで角膜輪部360度にわたるPOVの完全消失を認めたものは，熱・化学腐食39眼中32眼82％，Stevens-Johnson症候群30眼中25眼83％，ocular pem-phigoid 8眼中8眼100％，トラコーマ10眼中10眼100％，放射線性角膜炎2眼中2眼100％，IDU長期使用者21眼中11眼52％，点眼薬頻回使用者22眼中10眼45％であった．一方，正常眼30眼，再発性角膜上皮剥離7眼，春期カタル10眼，乾性角結膜炎10眼ではPOVは全例に存在した．以上のように，POVの消失は通常の角膜上皮疾患では認められず，難治性角結膜上皮疾患で高頻度に認められた．また，POVの消失した周辺部角膜には上皮直下の表層性角膜血管新生を高頻度に認めた．今回の結果から推定して，角膜におけるPOVの消失は角結膜上皮疾患に特徴的な臨床所見と考えられた．

We evaluated the clinical manifestations of palisades of Vogt in various ocular surface diseases. We observed a complete disappearance of the palisades in 32 out of 39 cases of thermal or chemical injuries, 25 out of 30 Stevens-Johnson syndrome, 8 out of 8 ocular pem-phigoids, 10 out of 10 trachomas, 2 out of 2 radiation keratitis, 11 out of 21 IDU abusers, and 10 of 22 instances of unspecified etiologies including frequent usage of eyedrops. Normal structure of palisades was maintained in normal subjects as well as patients with recurrent corneal erosion, vernal conjunctivitis and keratoconjunctivitis sicca. A close relationship was present between disappearance of palisades and super-ficial vascularization in the peripheral cornea. The findings indicate that the disappearance of palisades of Vogt is a highly specific clinical manifestation in so-called primary ocular surface diseases.