抗アクアポリン4抗体陽性視神経炎の視野変化

Visual field in optic neuritis with seropositive anti-aquaporin 4 antibody

要約　目的：抗アクアポリン4（AQP4）抗体陽性の視神経炎での視野障害の報告。対象と方法：抗AQP4抗体が陽性である視神経炎患者9例14眼を対象とした。すべて女性で，年齢は35～71歳（平均48歳）であった。発症からの期間は0～16年（平均4.8年）で，5眼が視神経乳頭炎，9眼が球後視神経炎であった。視野測定にはGoldmannまたはHumphrey自動視野計を用いた。結果：視力は0～0.8で，7眼が0.01以下であった。視野は中心暗点2眼，耳側欠損5眼，水平半盲2眼，全視野欠損3眼であり，非調和性半盲が1例にあった。結論：中心暗点以外の視野障害，特に耳側半盲がある視神経炎では抗AQP4抗体陽性視神経炎の可能性がある。

Abstract.　Purpose：To report the pattern of visual field defect in optic neuritis with seropositive anti-aquaporin 4（AQP4）antibody. Cases and Method：This study was made on 14 eyes of 9 patients with optic neuritis who were seropositive for AQP4 antibody. All were females. The age ranged from 35 to 71 years,average 48 years. They were seen after an interval between zero to 16 years,average 4.8 years,after onset. Optic neuritis was present in 5 eyes and retrobulbar neuritis in 9 eyes. Visual field was measured either by Goldmann or Humphrey perimeter. Findings：Visual acuity ranged from zero to 0.8. Seven eyes had visual acuity below 0.01. Perimetry showed central scotoma in 2 eyes,temporal defect in 5 eyes,horizontal hemianopia in 2 eyes,and total field defect in 3 eyes. One case showed incongruous bilateral hemianopia. Conclusion：Anti-AQP4-antibody may be the underlying cause for optic neuritis with atypical visual field defect including bitemporal hemianopia.