ロービジョン外来を受診した黄斑部萎縮の8症例におけるFunctional Vision Score評価

Eight cases of myopic maculopathy evaluated with the Functional Vision Score at the Low Vision Clinic of the Inouye Eye Hospital

要約　目的：当院のロービジョン（LV）外来を受診した近視性黄斑症の8例についてFunctional Vision Score（FVS）の評価を行ったので報告する。

対象と方法：対象は2019年1月〜2020年3月にLV外来を受診し，カルテの眼底写真より近視性黄斑症の国際分類のカテゴリー3，4と判定した8例を対象とした。平均年齢は77.0±11.1歳（55〜91歳），性別は全8例が女性であった。合併疾患は緑内障が2例4眼，角膜変性が1例2眼，黄斑円孔が1例1眼であった。視力・視野，身体障害者手帳（手帳）の等級，FVS，LVケアについて後ろ向き調査を行った。

結果：視力良好眼の視力は0.02〜0.3であった。視野は，5例で両眼の中心暗点もしくは傍中心暗点を，3例で片眼の中心暗点もしくは傍中心暗点を認めた。視覚の手帳は全員が取得しており，等級は1級2例，2級3例，4級2例，5級1例であった。FVSは4〜43（平均24±15）で，American Medical Association classを用い判定すると，class 4の全視覚障害が3例，class 3bの極度視覚障害が2例，class 3aの重度視覚障害が3例であった。LVケアでは4例で補助具が必要で音声図書・音声グッズの使用が適用となった。

結論：FVS判定では3例が全視覚障害に該当し，音声補助具が必要で，他5例もclass 3の極度視覚障害もしくは重度視覚障害に該当し，音声補助具が必要であった。

Abstract　Purpose：To report 8 cases based on the fundus findings of myopic maculopathy, who were evaluated using the Functional Visual Score（FVS）at the Low Vision Clinic of Inouye Eye Hospital.

Cases and methods：This retrospective study included 16 eyes of 8 patients in categories 3 and/or 4 of the new classification, based on the fundus findings of international classification myopic maculopathy, who visited the Low Vision Clinic of Inouye Eye Hospital between January 2019 and March 2020. All cases were female, and the average age was 77.0±11.1 years（55-91 years）. Other diseases were glaucoma in 4 eyes of 2 patients and, corneal degeneration in 2 eyes of 1 patient, and macular hole in 1 eye of 1 patient. We assessed the efficacy of was visual acuity, visual field, visually handicapped status, and FVS.

Results：The visual acuity of the better eye was 0.02 to 0.3. In the visual fields, central scotoma or paracentral scotoma was observed in both eyes in 5 cases, and central scotoma or paracentral scotoma in 1 eye was observed in 3 cases. All cases had visually handicapped status, and the grades were 1st grade in 2 cases, 2nd grade in 3 cases, 4th grade in 2 cases, and 5th grade in 1 case. The FVS was 4 to 43（mean 24±15）. Based on American Medical Association class, 3 cases had total visual loss of class 4, 2 cases had extreme visual loss of class 3b, and 3 cases had severe visual loss of class 3a. In low vision care, audio books and audio goods were useful in 4 cases.

Conclusion：There were 3 cases had total visual loss by FVS. The other 5 cases were also class 3 or higher, they correspond to profound or severe visual loss by FVS. They needed voice aids.