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要約 62歳男性が3週間前からの左眼霧視で受診した。糖尿病の既往があり,3年前に両眼に白内障手術を受けている。矯正視力は右0.8,左0.4であり,眼圧は右22mmHg,左26mmHgであった。左眼の虹彩と隅角に新生血管があり,両眼の眼底周辺部に無血管野があった。蛍光眼底造影による腕-網膜循環時間が約25秒と延長していた。脳血管造影で両側の内頸動脈に軽度の狭窄があった。これらの所見から,眼虚血症候群が疑われた。眼病変と視力はいったん改善したが,初診から5か月後に右眼隅角に新生血管が生じ,眼圧が上昇した。両眼の汎網膜光凝固を行い,以後の1年間,眼病変は寛解している。内頸動脈狭窄症が眼虚血症候群と血管新生緑内障の原因であった症例である。
Abstract. A 62-yaer-old diabetic male presented with blurring in the left eye since 3 weeks before. He had received cataract surgery in both eyes 3 years before. His corrected visual acuity was 0.8 right and 0.4 left.His intraocular pressure(IOP)was 22 mmHg right and 26 mmHg left. Rubeosis was present in the iris and chamber angle of the left eye.Both eyes showed capillary nonperfusion in the peripheral retina.Arm-to-retina circulation time was 25 sec. Magnetic resonance angiography showed slight constriction of bilateral carotid arteries. These findings led to the diagnosis of ocular ischemic syndrome. Rubeosis in the chamber angle of the right eye developed 5 months later associated with elevated IOP. Panretinal photocoagulation was performed in both eyes. He has been doing well during the follow-up for one year. This case illustrates that stenosis of carotid artery may induce ocular ischemic syndrome with neovascular glaucoma.
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