後部強膜炎に合併したと考えられた視神経周囲炎の4例

Four cases of optic perineuritis associated with posterior scleritis

目的：後部強膜炎に併発した視神経周囲炎4症例の報告。症例と経過：男性2例，女性2例で，年齢は43～55歳，平均48歳であり，2例は片眼性，2例は両眼性であった。視力は後部強膜炎と同時に低下し，炎症が視神経鞘に波及した結果と考えられた。副腎皮質ステロイド薬のパルス療法が全例で奏効したが，3例では内服漸減中に再発した。1例に海綿静脈洞炎，1例に外眼筋炎が併発した。視神経周囲炎は再発性かつ多発性であり，眼窩炎性偽腫瘍に酷似していた。結論：強膜炎または視神経周囲炎は広義の眼窩炎性偽腫瘍の一型と考えるべきであり，眼窩内外組織の検索と経過観察が望まれる。

Purpose：To report four cases of optic perineuritis associated with posterior scleritis. Cases and Findings：This retrospective study comprised 2 males and 2 females. Their age ranged from 43 to 55 years,average 48 years. Two cases were unilaterally and 2 cases were bilaterally involved visual acuity decreased after onset of posterior scleritis,presumably due to extension of inflammation to optic nerve sheath. Pulsed corticosteroid therapy was effective in all the cases. Optic perineuritis recurred during tapering in 3 cases. One case developed ocular myositis and another developed cavernous sinusitis. Optic perineuritis in the present series was characterized by multiple and recurrent occurrence,simulating inflammatory pseudotumor of orbit. Conclusion：Posterior scleritis and optic perineuritis is to be regarded as manifestation of inflammatory pseudotumor of orbit. Due attention is to be paid to orbital and extraorbital lesions in this entitiy.