両眼性視神経乳頭腫脹を呈した骨髄異形成症候群の1例

Bilateral optic disc swelling in a case of myelodysplastic syndrome

52歳女性が両眼の視力低下で受診した。2年前に貧血を契機として骨髄異形成症候群と診断された。矯正視力は右0.6，左0.2で，両眼に網膜出血と視神経乳頭腫脹があった。全身的に貧血と汎血球減少があり，免疫抑制療法と輸血などを開始した。15か月後に視力は正常化し，眼底所見も大きく改善した。骨髄異形成症候群で乳頭腫脹が生じた報告はない。慢性化した貧血が急激に悪化し，血小板減少がこれに加わったことで発症したと推定される。

A 52-year-old female presented with impaired visual acuity in both eyes. She had been diagnosed with anemia and myelodysplastic syndrome 2 years before. Her corrected visual acuity was 0.6 right and 0.2 left. Both eyes showed retinal hemorrhage and optic disc swelling. Laboratory studies showed anemia and pancytopenia. She received immunosuppressive therapy with blood transfusion. Her visual acuity became normal 15 months later with improved fundus findings. There has been no reported case of myelodysplastic syndrome with optic disc swelling. It appeared that the observed fundus findings were induced by acute exacerbation of chronic anemia and pancytopenia.