ぶどう膜炎に合併した眼内新生血管

Intraocular neovascularization associated with uveitis

　眼内新生血管を合併したぶどう膜炎の3症例を経験した。それぞれ原田病，ベーチェット病，結核性ぶどう膜炎である。原田病では，後極部の漿液性網膜剥離と脈絡膜剥離，乳頭浮腫，乳頭上新生血管があり，大量ステロイド療法で新生血管は徐々に縮小した。ベーチェット病では，網膜と乳頭上に新生血管があり，ステロイド薬の局所投与と免疫抑制薬で消炎し，新生血管は退縮した。結核性ぶどう膜炎では，抗結核療法とステロイド薬内服で眼内炎が沈静化し，新生血管は縮小傾向を示した。原田病と結核性ぶどう膜炎の2例には経過中に網膜の無血管領域にレーザー光凝固を行ったが，これによる炎症再燃はなかった。ぶどう膜炎に併発した眼内新生血管が，原疾患の消炎で退縮することを示した。

We observed three cases of intraocular neovascularization associated with uveitis. They were Vogt-Koyanagi-Harada (VKH) syndrome, Behçet disease and tuberculous retinal vasculitis respectively. In the case of VKH syndrome, both eyes showed serous retinal and choroidal detachment in the posterior fundus, and disc neovascularization (NVD). Pulse corticosteroid therapy induced regression of NVD. In the case of Behçet disease, topical corticosteroid and oral cyclosporin induced regression of NVD and retinal neovascularization. In the case of tuberculous retinal vasculitis, systemic antituberculosis therapy and corticosteroid induced resolution of intraocular inflammation and retinal neovascularization. After acute ocular inflammation had subsided, laser photocoagulation was applied to the peripheral nonperfused retina in the case of VKH syndrome and tuberculous retinal vasculitis. There was no recurrence of intraocular inflammation following laser treatment. These cases illustrate that treatment for causative uveitis may result in regression of intraocular neovascularization.