視力，視野障害を伴った視神経乳頭上色素性腫瘍の1例

A case of pigmented tumor of the optic disc with impaired visual acuity and field

要約　目的：視神経乳頭上色素性腫瘍に視力と視野障害が併発した症例の報告。症例：48歳女性が健康診断で眼底異常を指摘された。矯正視力は右1.2，左0.9であった。左眼の視神経乳頭前に1.5乳頭径の黒褐色の隆起性病変があった。同様な病変は8年前にも当院で確認されていた。ゴールドマン視野検査で左眼の鼻下側に狭窄があった。経過中に左眼視力が0.9と1.2の間を変動した。眼底所見から良性の黒色細胞腫が強く疑われたが，本症例では視力が変動し，視野異常があることが特異的であった。結論：視神経乳頭の黒色細胞腫で視力と視野障害が生じたのは，腫瘍による視神経線維の圧迫または視神経内血管の循環障害による可能性がある。

Abstract.　Purpose：To report a case of pigmented tumor of the optic disc with impaired vision and visual field. Case and Findings：A 48-year-old woman was referred to us for funduscopic anomaly detected by routine health check-up. Her corrected visual acuity was 1.2 right and 0.9 left. Her left fundus showed a pigmented tumor of 1.5 disc diameters across anterior to the optic disc. The same lesion had been seen by us 8 years before. Goldmann perimetry showed constriction of visual field in the nasal inferior periphery. The left visual acuity fluctuated between 0.9 and 1.2 during the follow-up period. The fundus findings were strongly suggestive of melanocytoma of the optic disc, although this clinicopathological entity is usually free of impaired vision or visual field. Conclusion：There is a possibility that the observed impaired vision and visual field was induced by pressure to the optic nerve fibers or impaired circulation in the optic nerve head.