心因性視覚障害―世代別にみた傾向と特異性

Psychogenic visual disturbances. Age-related tendency and characteristic features

要約　目的：心因性視覚障害と診断した患者につき，世代別の病態の特徴，診断の根拠，推定心因などについての報告。対象：過去12年間に心因性視覚障害と診断した180症例を診療録に基づいて検索した。男性51例，女性129例で，年齢別の内訳は，13歳未満の小児66例，20歳までの思春期41例，60歳までの成人56例，高齢者17例である。結果：推定心因は，小児と思春期では学校や家庭に関するストレスが上位を占め，成人では仕事や家庭など生活に関するストレス，高齢者では孤独，経済問題，疾病に関するストレスが多かった。病態の特徴として，小児と思春期では心因が単純で治療しやすい症例が多く，成人と高齢者では心因が複雑で治癒しにくい傾向があった。結論：心因性視覚障害は全年齢層にあり，成人と高齢者では，小児や思春期とは異なり難治例が多い。

Abstract.　Purpose：To report clinical features, reasons for diagnosis and presumed causes of psychogenic visual disturbances in different age groups. Object：This retrospective study was made on 180 cases of psychogenic visual disturbance diagnosed during the past 12-year-period. The series comprised 51 males and 129 females, and included 66 children under 13 years of age, 41 adolescents up to 20 years, 56 grown-ups up to the age of 60 years, and 17 senile persons. Results：Visual disturbances were mainly due to stress at school or home in children and adolescents, to stress regarding jobs or family life in grown-ups, and to stress due to loneliness, economical matters or disease in senile persons. As a general tendency, the underlying causes were simple and could be cured with ease in children and adolescents. Multiple causes were involved in grown-ups and senile persons and ran protracted causes. Conclusion：Psychogenic visual disturbances involve persons in all generations and tend to persist longer in grown-ups and senile persons than in children and adolescents.Rinsho Ganka（Jpn J Clin Ophthalmol）62（4）：503-508, 2008