Terson症候群に両眼外転神経麻痺を合併した1例

A case of Terson syndrome with bilateral abducens palsy

要約　目的：Terson症候群に併発した両側の外転神経麻痺に手術が奏効した症例の報告。症例：55歳男性が両眼の視力低下と外転神経麻痺で紹介され受診した。3か月前にくも膜下出血があり，手術を受けたあと視力低下を自覚した。矯正視力は右手動弁，左0.15で，両眼に軽度の外転不全と硝子体出血があった。Terson症候群と診断し，硝子体手術を両眼に行った。視力は直後から回復したが，内斜視による複視を自覚した。8か月後に左眼に後転短縮手術を行い，複視はほぼ消失し，右1.0，左1.2の最終視力を得た。結論：Terson症候群には外転神経麻痺が併発することがある。これによる複視には手術による眼位矯正を考慮する必要がある。

Abstract.　Purpose：To report a case of Terson syndrome in whom surgery was effective for associated bilateral abducens palsy. Case and Findings：A 55-year-old man was referred for impaired visual acuity and abducens palsy in both eyes. He had had subarachnoid hemorrhage 3 months before. He noted blurring in both eyes after surgery. His corrected visual acuity was hand motion right and 0.15 left. Both eyes showed limited abduction and vitreous hemorrhage. He was diagnosed with Terson syndrome. Vitreous surgery resulted in diplopia due to improved visual acuity. Recession-resection surgery on the left eye was performed 8 months later and was followed by disappearance of diplopia and final visual acuity of 1.0 right and 1.2 left. Conclusion：Abducens palsy may be associated in Terson syndrome. Surgery may be indicated to correct diplopia.