梅毒性視神経萎縮の3症例—その臨床的特徴と今日的意義

THREE CASES OF SYPHILITIC OPTIC ATROPHY:ITS CLINICAL FEATURES AND SIGNIFICANCE

　抄録　梅毒性視神経萎縮の3症例を若干の文献的考察を加えて報告した。3症例ともに急激な視力低下，視野障害を呈し，そのうち2症例は軽度の脊髄虜の症状が出現する以前に発症し，ペニシリンなどの大量投与にもかかわらず，その視神経障害は進行性であった。神経梅毒を初めとする梅毒が著減しているといわれる現在，神経梅毒の病像，発生頻度に関して，文献的に検討するとともに，従来稀と考えられていた梅毒性視神経萎縮の今日的意義について言及した。

All 3 cases showed progressive deteriorations of visual acuity, and visual field defects associated with central scotoma. Following optic nerve atro-phy, two of them developed the signs and sym-ptoms related to spinal cord involvements, which were considered to be early development of tabes dorsalis clinically.

After the introduction of penicillin into the therapy of syphilis, especially neurosyphilis, it has been said that this disease is markedly de-creased in incidence, and its clinical features are changed. However, there are some reports stating that neurosyphilis might be still prevalent and more atypical forms of neruosyphilis has been encountered.

The incidence of syphilitic optic atrophy is still rare, and there is no difference between its' incidence in old and recent reports.

From our recent experience and review of the literatures, it is proposed that we should never forget the existance of syphilis in differential diagnosis of optic nerve atrophy.