ステロイド治療を行ったAZOORの1例

A case of acute zonal occult outer retinopathy treated by systemic corticosteroid

要約　目的：両眼性の急性帯状潜在性網膜外層症（AZOOR）の1症例の報告。症例：22歳女性が6週間前からの両眼視力低下と下方視野の欠損で受診した。所見：矯正視力は右0.9，左0.8で，下方視野の欠損が両眼にあった。前眼部，透光体，眼底に異常はなく，頭部磁気共鳴画像検査（MRI）と蛍光眼底造影でも異常はなかった。多局所網膜電図で視野欠損に一致して振幅低下があり，AZOORと診断した。初診から6週間後にステロイドパルス療法を開始し，漸減後プレドニゾロン内服に切り替えた。治療開始から6か月の間，視力と視野に変化または改善はない。結論：AZOORにはステロイドの全身投与が奏効しない症例が存在する。

Abstract.　Purpose：To report a case of acute zonal occult outer retinopathy（AZOOR）that failed to respond to systemic corticosteroid therapy. Case：A 22-year-old female presented with impaired visual acuity and visual field defect since 6 weeks before. Findings：Corrected visual acuity was 0.9 right and 0.8 left. Both eyes showed visual field defect in the lower sector. Findings by ophthalmoscopy,magnetic resonance imaging（MRI）of the brain,and fluorescein angiography were inconspicuous. Multifocal electroretinography showed reduced responses in areas of defective visual field. The findings led to the diagnosis of AZOOR. Pulsed corticosteroid therapy followed by peroral prednisolone showed no changes in visual acuity or visual field after 6 months. Conclusion：The present case illustrates that systemic corticosteroid may not be effective for AZOOR.