ボリコナゾール内服中に著明な視力低下をきたした強度近視の1例

Marked visual impairment during peroral voriconazole in a case of high myopia

要約　目的：強度近視があり，ボリコナゾール内服中に顕著な視力低下が生じた症例の報告。症例：74歳男性が6日前からの両眼の霧視で受診した。強度近視と色覚異常があり，11年前の白内障手術後も視力が不良であった。16か月前から肺炎で加療中であり，3週間前にアスペルギルスが気管支から検出され，7日前にボリコナゾールの内服を開始した。所見：矯正視力は右0.04，左0.01で，両眼とも乳頭が蒼白であった。受診の2日後にボリコナゾール内服を中止した。その直後から霧視が減少し，6週間後に視力が右0.08，左0.1になり発症前の状態に戻った。結論：ボリコナゾール内服で視力低下が起こる可能性があり，低視力者では特に留意する必要がある。

Abstract.　Purpose：To report a case who developed marked visual impairment during systemic treatment with voriconazole. Case：A 74-year-old male presented with blurring in both eyes since 6 days before. He had been treated for pneumonia for 16 months. Aspergillus was detected in the bronchus 3 weeks before. He had been receiving peroral voriconazole since 7 days before. He had achromatopsia and high myopia. Visual acuity had been poor even after cataract surgery 11 years before. Findings：Corrected visual acuity was 0.04 right and 0.01 left. Both eyes showed pale optic disc. After discontinuation of peroral voriconazole,visual acuity started to improve immediately and reached 0.08 right and 0.1 left 6 weeks later. Conclusion：Peroral voriconazole may induce impaired visual acuity. This possibility must be kept in mind particularly in persons with amblyopia.