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39歳,女性,頭蓋内悪性黒色腫の急速な眼窩内進展によると思われる,右眼網膜中心動脈閉塞症により失明した症例について報告した.本症例は13年前に対側の左眼窩腫瘍に対して眼球摘出を受けているが,その病理組織学的診断が不明であり,今回の腫瘍との関連性についても不明である.その後本症例は右頭蓋内腫瘍摘出および肝転移巣の摘出を受け,現在化学療法および放射線療法施行中である.網膜中心動脈閉塞症の原因としての腫瘍の眼窩内進展はきわめて稀なものであり,文献的考察を加えて報告した.
A 39-year-old female presented with acute exo-phthalmos, chemosis and visual loss in her right eye. Funduscopy showed atypical occlusion of central retinal artery. Blindness resulted in spite of energic therapeutic measures. Exenteration of the left orbit had been performed 12 years before on account of orbital tumor of unidentified nature.
The present condition was diagnosed as consequence of cerebral malignant melanoma invading the right orbit. Occlusion of the central retinal artery due to orbital tumor is a very rare occurrence. In the present case, central retinal artery seemed to be occluded due to local compression in the orbit and not to tumor emboli.
Rinsho Ganka (Jpn J Chn Ophthalmol) 40(7) : 799-802,1986
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