相対的求心性瞳孔障害が陽性となったacute zonal occult outer retinopathyの1例

A case of acute zonal occult outer retinopathy with relative afferent pupillary defect

　25歳女性が8週前からの右眼耳側視野欠損で受診した。視力は左右とも1.5で，瞳孔の直接対光反応は右遅鈍，左迅速であり，相対的求心性瞳孔障害が右眼で陽性であった。視野検査で盲点拡大が右眼にあった。眼底検査，蛍光眼底造影，視覚誘発電位，磁気共鳴断層撮影で異常所見はなかった。多局所網膜電図で，視野欠損部に対応する部位に応答低下があった。これらの所見からacute zonal occult outer retinopathyと診断した。視野欠損は自然回復した。相対的求心性瞳孔障害が陽性であったのは網膜障害の結果であると推定した。

　A 25-year-old woman presented with visual field defect in her right eye since 8 weeks before. Her visual acuity was 30/20 in either eye. Direct pupillary light reflex was delayed right and prompt left. The right eye showed relative afferent pupillary defect. The right eye showed enlarged blind spot. No abnormal findings were detected by funduscopy,fluorescein angiography,visual evoked potential,or magnetic resonance imaging. Multifocal electroretinography was depressed in areas corresponding to the visual field defect. These findings led to the diagnosis of acute zonal occult outer retinopathy. The visual field defect resolved spontaneously. Retinal lesions seemed to have been the cause of observed relative afferent pupillary defect.