網膜有髄神経線維を伴う弱視の3例

Amblyopia in three cases of myelinated retinal nerve fibers

要約　目的：網膜有髄神経線維に弱視を伴った3症例の報告。症例：症例は3歳女児，6歳男児，7歳女児であり，矯正視力は健眼ではそれぞれ1.0，1.2，1.2で，患眼では0.01，0.15，0.2であった。屈折は健眼ではそれぞれ－1.0D，＋1.0D，－0.5Dで，患眼では－6.0D，－6.0D，－6.25Dであった。網膜有髄神経線維はいずれも乳頭から連続し，最初の2例では上方の血管アーケードに沿い，第3例では黄斑の上下を囲んでいた。いずれも黄斑には及んでいなかった。経過：眼鏡による屈折矯正と遮閉訓練で，症例1では2年後に矯正視力が0.5に，症例2では13か月で0.2に，症例3では10か月で0.3になった。結論：片眼の網膜有髄神経線維に近視と弱視がある若年の3症例に，屈折矯正と弱視訓練で視力の改善が得られた。

Abstract.　Purpose：To report 3 cases who had unilateral myelinated retinal nerve fibers,myopia,and amblyopia. Cases：The present series comprised a girl aged 3 years,a boy aged 6 years,and a girl aged 7 years. Visual acuity in the healthy eye was 1.0,1.2 and 1.2 without correction. Corrected visual acuity was 0.01,0.15 and 0.2 in the affected eye. Refraction in the healthy eye was －1.0D,＋1.0D and －0.5D and was －6.0D,－6.0D and －6.25D respectively in the affected eye. Myelinated retinal nerve fibers were located in the superior vascular arcade in 2 cases and along the superior and inferior vascular arcades in the other. There was no case with involvement of the macula. Clinical Outcome：All the 3 cases received orthoptic treatment after correction of myopia by spectacles. Visual acuity improved to 0.5 after 2 years in Case 1,to 0.2 after 13 months in Case 2,and to 0.3 after 10 months in Case 3. Conclusion：These cases illustrate that visual acuity may improve in eyes with amblyopia,myopia and unilateral myelinated retinal nerve fibers by proper treatment.