視神経乳頭ドルーゼン自験例7症例の臨床報告と本邦文献77症例の分析

Optic disc drusen. Report of 7 cases and review of 77 cases in Japanese literature

　当科外来にて，視神経乳頭ドルーゼン7症例13眼（表在型5例：9眼，埋没型2例：4眼）を経験した．これら7症例は我々の外来の新来総患者の0.04％に相当する．臨床所見の分析結果から得られた興味深い点は，網膜色素変性症を併発する症例では視神経乳頭は正常大で乳頭上の血管の走行や分岐にも異常は認められなかったが，特発性の症例では乳頭径は正常より小さく血管の分岐異常や走行異常を示すものが多かったことで，本症の成因に有用な示唆を与えるものと考えた．

　さらに，上記7症例を含めた，わが国での報告例77症例の臨床所見，併発症などの分析を行った．

We observed optic disc drusen in 13 eyes in 7 patients. The condition was of exposed type in 9 eyes and was of buried type in 4 eyes. Retinitis pigmentosa was present in 2 cases. The optic disc was smaller in cases without retinitis pigmentosa. Vascular abnormalities in the disc were found in all the 13 eyes.

We reviewed 77 cases of optic disc drusen reported in Japanese literature including our present 7 cases. There were 31 males, 21 females and 25 ambiguous cases. Thecondition appeared as exposed type in 50 cases, buried type in 13 and unclarified in 14. It occurred bilaterally in 25 cases and unilaterally in 24. It was associated with retinitis pigmentosa in 27 cases, with angioid streaks in 7, diabetic retinopathy in 2, retinal vein occlusion in 2 and tuberous sclerosis in 1. Retinal or subretinal hemor-rhage was present in 10% of the cases. The drusen was located over the entire disc surface in 12 eyes, nasal half of the disc in 16, temporal half in 4, and other wise in 9 eyes. The visual acuity was slightly impaired in 33% of the cases. Visual field defect was present in 90% of the cases without retinitis pigmentosa. Consanguinity of parents was present in 5 cases with retinitis pigmentosa. The 4 cases with angioid streaks were actually 2 pairs of father and son.

Rinsho Ganka(Jpn J Clin Ophthalmol) 40(8) : 885-889. 1986