就労相談から診断に至ったオカルト黄斑ジストロフィの1例

Counseling for continuation of work led to the diagnosis of occult macular dystrophy

要約　目的：就労継続の相談の目的で受診し，オカルト黄斑ジストロフィの診断に至った症例の報告。症例：39歳男性が就労継続困難を訴え受診した。視神経疾患が疑われていた。所見：矯正視力は右0.4，左0.2で，眼底正常。光干渉断層計（OCT）では黄斑部の視細胞内節外節接合部ラインの不明瞭化を認めた。杆体・錐体系網膜電図は両眼とも正常。多局所網膜電図では両眼の中心部の著しい反応低下がみられた。オカルト黄斑ジストロフィと診断。運転業務はできないが，デスクワークは可能である診断書を会社へ提出した。結論：オカルト黄斑ジストロフィの診断にOCTは有用で，診断により就労継続が可能となった。

Abstract.　Purpose：To report a case who sought counseling due to poor vision in working and who was diagnosed with occult macular dystrophy. Case：A 39-year-old male presented with impaired vision and difficulty in continuing his work. He had been suspected of optic neuropathy elsewhere. His father and grandfather had reportedly poor vision. Findings：Best corrected visual acuity was 0.4 right and 0.2 left. The fundus was apparently normal. Optical coherence tomography（OCT）showed indistinct line between inner and outer photoreceptor segment. Cone and rod electroretinogram was normal. Multifocal electroretinogram（mERG）showed decreased response in the macular area. The findings led to the diagnosis of occult macular dystrophy. He was advised to continue his work except driving. Conclusion：OCT and mERG facilitated the diagnosis of occult macular dystrophy.