内頸動脈狭窄に併発した両眼の網膜動脈閉塞症の1例

Bilateral retinal artery occlusion in a case with carotid artery stenosis

（17-P1-12）　脳梗塞と高血圧の既往をもつ70歳の男性が，右眼に網膜中心動脈分枝閉塞症を発症し，3か月後，左眼に網膜中心動脈閉塞症が起こった。螢光眼底造影で左眼網膜中心動脈の造影遅延があり，頭部CTとMRIで小脳梗塞を，頸部MR angiographyで右頸動脈狭窄を，頭部MR angiographyで両側椎骨動脈の狭窄を発見された。本症例は頭頸部の動脈狭窄と脳梗塞があり，網膜動脈に閉塞症を生じやすい素因があって，両側性に病変を起こした可能性がある。当科で両眼性網膜動脈閉塞症はこの1例だけで，網膜動脈閉塞症全体41例の2.4％で，稀である。

A 70-year-old male developed branch retinal artery occlusion in his right eye and, 3 months later, central retinal artery occlusion in his left eye. He had a history of cerebral infarct and systemic hypertension. Cerebellar infarct was detected by computed tomography and magnetic resonance imaging. Magnetic resonance angiography showed stenosis of right carotid artery and stenosis of both vertebral arteries. Stenosis of carotid and vertebral arteries appeared to have been the underlying cause of bilateral retinal artery occlusion in this patient. This is the sole case of bilateral involvement out of a total series of 41 cases of retinal artery occlusion seen by us during the past 10-year period.