網膜血行が完全に途絶をした内頸動脈閉塞症の1例

Carotid artery occlusion resulted in ipsilateral cessation of retinal circulation. Report of a case

緒言

　内頸動脈などの閉塞または狭窄によって眼内循環血液量が低下し，眼球とくに前眼部に毛様充血，角膜浮腫，虹彩ルベオーシスなどの前眼部炎症様症状をきたす例は　Knox^1）により　ocular is-chemic inflammationとして最初に報告された。

　内頸動脈閉塞症に伴う眼症状として，自覚的には一過性黒内障発作，一過性視野欠損，色視症，複視，視力障害などが，他覚的には球結膜充血，虹彩毛様体炎，血管新生緑内障，白内障，瞳孔不同，眼球運動障害などがある。眼底変化としては’網膜動脈閉塞症^2〜4），虚血性視神経症^5,6），高血圧性網膜症^7），網膜中心静脈閉塞症^8）などの症状を呈することが知られている。

A 51-year-old male presented with repeated amaurosis fugax as chief complaint. He was diagnosed as hypertensive retinopathy. Abrupt impariment in left vision developed 2 months later. Hypotensive retinopathy and rubeosis iridis were observed. Neovascular glaucoma had developed when seen by us 2 months after the episode.

Fluorescein fundus angiography showed striking delay in choroidal circulation and complete cessa-tion of retinal circulation. Digital subtraction an-giography of the carotids revealed occlusion of the left carotid artery at the site of bifurcation. No reinstitution of retinal circulation set in during the following 17 months of observation.

Attenuation or occlusion of internal carotid artery is to be suspected as one of the possible causes of hypotensive retinopathy or central retinal artery occlusion.