眼所見を呈した抗リン脂質抗体症候群の6例

Six cases of antiphospholipid antibody syndrome with eye involvement

　眼底の血管閉塞性病変を呈した抗リン脂質抗体症候群の6例を検討した。6例中5例は，内科または皮膚科で本症候群と診断されている全身性エリテマトーデス（systemic lupus erythematosus：SLE）の患者で，眼科的には網膜動脈や静脈の閉塞症，軟性白斑，虚血性視神経症，神経線維層欠損などがみられた。従来SLEによる網膜症とされていたもののなかに，本症候群の血栓形成傾向が関与していた可能性がある。他の1例は，明らかな自己免疫疾患のない81歳の男性で，右眼網膜の動脈分枝閉塞症と中心静脈閉塞症を発症し，免疫学的検索でループス抗凝固因子が検出され，本症候群と診断された。眼科領域でも血管閉塞性疾患をみた場合，抗リン脂質抗体を積極的に検索すべきである。

We observed 6 cases of retinal vasoocclusive lesions associated with antiphospholipid antibody syndrome. Five were females with systemic lupus erythematosus, SLE. They were diagnosed as antiphos-pholipid antibody syndrome by internists or dermatologists. The fundus lesions comprised occlusion of retinal artery and/or vein, soft exudateds, ischemic optic neuropathy and nerve fiber layer defect. A hypercoagulable state in this syndrome appeared to have led to thrombosis and to so-called SLE retinopathy. The sixth case, an 81-year-old male, showed no manifest autoimmune disease. Funduscopy showed branch retinal artery and central retinal vein occlusion in the right eye. He was positive for lupus anticoagulant and was diagnosed as antiphospholipid antibody syndrome. The findings show that antiphospholipid antibody may be involved in vasoocclusive lesions of the retina.