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要約 目的:姿勢保持が困難な患者のステロイド緑内障を,ヘッドマウント型視野計imo®で評価した報告。
症例:38歳の女性が左眼の視力低下で受診した。6歳時に全身性若年性特発性関節炎と診断され,全身の関節障害があり,プレドニゾロンの経口投与を28年間受けていた。
所見と経過:矯正視力は右1.2,左0.7で,眼圧は右25mmHg,左45mmHgであった。左眼に乳頭陥凹の拡大があった。ステロイド緑内障と診断し,点眼と内服による治療を開始した。左眼が高眼圧を維持したため,2か月後に線維柱帯術切開術を行った。経過中,imo®により視野を評価した。右眼には病的所見がなく,左眼の視野障害は不変であった。
結論:姿勢保持が困難な緑内障患者での視野の評価と治療方針の決定に,imo®による検査が有用であった。
Abstract Purpose:To report an orthopedically disabled case of steroid glaucoma evaluated by a head-mounted perimeter.
Case:A 38-year-old female presented with blurring of vision in the left eye. She had been diagnosed with systemic juvenile idiopathic arthritis at the age of 6 years and been receiving peroral prednisolone since 10 years of age. She showed stiffness at multiple joints of the extremities.
Findings and Clinical Course:Corrected visual acuity was 1.2 right and 0.7 left. Intraocular pressure(IOP)was 25 mmHg right and 45 mmHg left. The left eye showed enlarged disc cupping. Topical and systemic medication was started under the diagnosis of steroid glaucoma. IOP in the left eye failed to respond to treatment, necessitating trabeculotomy 2 months later. The visual field was evaluated by “imo®”. The right eye showed no pathological changes. The left eye showed the same changes throughout the course.
Conclusion:Findings by head-mounted perimeter “imo®” was useful in the evaluation and follow-up of glaucoma in a orthopedically disabled patient.
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