潰瘍性大腸炎の加療中にステロイドの減量に伴って発症した網膜中心静脈閉塞症の1例

Central retinal vein occlusion in a case during tapering of systemic corticosteroid for ulcerative colitis

要約　目的：潰瘍性大腸炎に対するプレドニゾロン減量中に網膜中心動脈閉塞症が発症した症例の報告。症例：41歳男性が1か月前からの左眼視力低下で受診した。2年前に潰瘍性大腸炎が発症し，ステロイド内服で寛解した。5か月前に潰瘍性大腸炎が再発し，プレドニゾロンを1日量50mgの内服を開始し，10mgまで減量中であった。所見：矯正視力は左右眼とも1.2であり，左眼に切迫型の網膜中心動脈閉塞症の所見があった。プレドニゾロンを40mgに増量し，その2か月後に眼底所見が正常化した。結論：潰瘍性大腸炎に対するプレドニゾロン減量中に網膜中心動脈閉塞症が発症し，増量後に寛解した。

Abstract.　Purpose：To report a case who developed unilateral central retinal vein occlusion（CRVO）during tapering of systemic prednisolone for ulcerative colitis. Case：A 41-year-old male presented with impaired vision in the left eye since one month before. He had had ulcerative colitis 2 years before that subsided after peroral corticosteroid. Ulcerative colitis recurred 5 months before. He had been receiving peroral prednisolone with initial daily dosis of 50 mg reduced to 10 mg. Findings：Corrected visual acuity was 1.2 in either eye. The left eye showed findings compatible with impending CRVO. He started receiving 40 mg of prednisolone per day. The fundus findings became normal 2 months later. Conclusion：CRVO developed during tapering of peroral prednisolone and subsided after increase of daily dosis.