Spectral-domain OCTにて網膜内層の菲薄化を認めた栄養欠乏性視神経症の1例

A case of nutritional optic neuropathy with thinning of inner retinal layer by spectral-domain optic coherence tomography

要約　目的：栄養欠乏性視神経症の網膜所見を光干渉断層計で見た報告。症例：68歳，男性，アルコール中毒。栄養失調・貧血で救急搬送され入院5日後に視力低下を主訴に受診した。所見：矯正視力は両眼とも（0.1）。限界フリッカ値低下と色覚異常，両眼の中心暗点を認めた。血液検査で葉酸，ビタミンC，ビタミンB₂が欠乏していたため，これらの補充療法を行った。治療開始後14週には視力は（0.6）となり，その他の視機能異常は回復した。治療後19週のspectral-domain OCT（SD-OCT）では網膜内層の菲薄化が観察され，治療後41週，61週の検査でも同様であった。結論：栄養欠乏性視神経症における網膜内層の菲薄化をSD-OCTを用いて定量的に評価することができた。

Abstract.　Purpose：To report a case of nutritional optic neuropathy observed by spectral-domain optic coherence tomography（OCT）. Case：A 68-year-old male was admitted in the emergency ward for anemia, malnutrition and alcoholism. He was referred to us for impaired vision 5 days later. Findings：Corrected visual acuity was 0.1 in either eye. Both eyes showed central scotoma, defective color vision, and decreased critical flicker fusion frequency. Hematological studies showed dereased levels of folic acid, vitamin C and B₂. Replacement therapy was followed by improved visual acuity to 0.6 in either eye 14 weeks later. Other ophthalmological findings improved also. Spectral-domain OCT showed thinning of inner retinal layer after 19 weeks of treatment. The finding persisted after 41 and 61 weeks of treatment. Conclusion：Thinning of inner retinal layer was an outstanding feature in a case of nutritional optic neuropathy.