ビタミンAを投与された網膜色素変性症例のGoldmann視野検査とHumphrey視野検査

Changes in Goldmann and Humphrey perimetry in cases of retinitis pigmentosa treated by vitamin A

要約　目的：ビタミンAの投与を受けた網膜色素変性の症例での視野の報告。対象と方法：眼底所見と電気生理学的所見とから網膜色素変性と診断された17例を対象とした。男性11例，女性6例で，投与開始時の年齢は28～70歳，平均44歳である。1日10,000IUのビタミンA（チョコラ^®A）を投与し，矯正視力の経過を追った。Humphrey視野検査を13例に行い，1年から4年，平均2.2年の経過を追った。Goldmann視野検査を全例に行い，1～15年（平均8年）の経過を追った。投与前の矯正視力は，0.7以上が30眼，0.5以下が4眼であった。結果：ビタミンA投与後の矯正視力は，0.7以上が31眼，0.5以下が3眼であった。29歳の症例では，左眼視力が投与前の0.4から7年後に1.2に改善した。Humphrey視野計によるMD値は，13例中6例（46％）で片眼のみが改善した。Goldmann視野計でのⅠ-2指標の面積は，17例中3例（18％）で両眼，4例（24％）で片眼のみが拡張した。Ⅴ-4指標の面積は，4例（24％）で両眼，3例（18％）で片眼のみが拡張した。結論：網膜色素変性に対するビタミンAの長期投与で，一部の症例で視野が改善した。改善は，HumphreyとGoldmann視野でほぼ同等であった。

Abstract.　Purpose：To report changes in visual field in cases of retinitis pigmentosa treated by peroral vitamin A. Cases and Method：This study was made on 17 patients who were diagnosed with retinitis pigmentosa based on fundus and electrophysiological findings. The series comprised 11 males and 6 females. Age at the start of treatment ranged from 28 to 70 years, average 44 years. Each patient was treated by peroral vitamin A at the daily dosis of 10,000IU. Humphrey perimetry was performed in 13 cases for one to 4 years, average 2.2 years. Goldmann perimetry was performed in all the cases for one to 15 years, average 8 years. Corrected visual acuity before treatment was 0.7 or over in 30 eyes and 0.5 or less in 4 eyes. Results：Corrected visual acuity after treatment was 0.7 or over in 31 eyes and 0.5 or less in 3 eyes. Left visual acuity improved from 0.4 to 1.2 seven years later in a patient aged 29 years. MD value by Humphrey perimetry improved unilaterally in 6 out of 13 cases（46％）. Area of visual field by Ⅰ-2 target by Goldmann perimeter enlarged bilaterally in 3 out of 17 cases（18％）and unilaterally in 4 cases（24％）. Area by Ⅴ-4 target enlarged bilaterally in 4 cases（24％）and unilaterally in 3 cases（18％）. Conclusion：Treatment with vitamin A was followed by improved visual field in some cases of retinitis pigmentosa. Improvement was essentially similar by Goldmann and Humphrey perimetry.