眼内液にのみウイルス抗体価の上昇をみた桐沢型ぶどう膜炎の1症例

Increased antibody titer for herpes zoster virus in the intraocular fluids in a case of Kirisawa uveitis

　桐沢型ぶどう膜炎の症例の前房水，硝子体液ならびに網膜下液のウイルス抗体価を経過を追って測定し，血清中のそれと比較した．また，抗体率も計算した．

　罹患眼においてのみ，眼内液中のHerpes Zos-ter Virus （HZV）の抗体価の明らかな上昇を認めた．罹患眼のHZVの抗体率も著しく上昇していた．しかし血清中のHZVの抗体価は非常に低値であった．

　眼内においてのみHZVの抗体価が上昇し，血清中のそれは低値であったことより，この桐沢型ぶどう膜炎では，HZVが眼内だけにおいて起炎抗原となった可能性があると考えた．

A 69-year-old male manifested typical clinical features of acute retinal necrosis, or Kirisawa-type uveitis in his left eye. Besides systemic corticoster-oid and acyclovir treatment, surgery became neces-sary to treat retinal detachment 12 weeks after occurrence of the disease.After an initial favorable course under systemic corticosteroid and acyclovir, retinal detachment developed 12 weeks after onset, necessitating two repeated surgeries. Lasting cure was attained 5 months after onset.

We tapped the anterior chamber for im-munological studies on 6 occasions during the course of the disease. We also subjected the vitreousand the subretinal fluid to viral antibody titer evalu-ation for herpes simplex virus (HSV), herpes zoster virus (HZV) and cytomegalovirus (CMV). The antibody titer for HZV was 64 to 2,048x in the intraocular fluids and 32 to 128 in the serum. When corrected for IgG content in the samples, the antibody ratio was 16.9 or more. In a similar study, the antibody titer was less than 4.4 for HSV and less than 3.1 for CMV, No antibody to the viruses was detected in the aqueous humor samples from the fellow eye.

The findings indicate that HZV was involved in the etiology of Kirisawa uveitis in this case.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(8) : 902-906, 1987