脳室周囲白質軟化症に視神経異常と外斜視を合併した1例

A case of periventricular leukomalacia associated with exotropia and optic nerve abnormality

　外斜視に視神経異常および視野欠損を合併し．MRI検査で脳室周囲白質軟化症（periventricularleukomalacia：PVL）がみられた22歳女性の1例を報告した。周産期に頭蓋内出血の既往があり，これがPVLの成因と推察した。PVLが本症例にみられた外斜視，視神経異常の原因と考えた。外斜視に対する手術により整容治癒は得られたものの，立体視の獲得はできなかった。乳幼児期に早期診断・治療ができていれば，よりよい治療結果が得られた可能性もあり，PVLの早期診断とこれによる眼合併症の早期発見・早期治療が望まれる。

A 22-year-old female presented with exotropia, bilateral visual field defect and unilaterally enlarged optic disc.Magnetic resonance imaging showed periventricular leukomalacia.It appeared that intracranial hemor-rhage during the perinatal period caused periventricular leukomalacia followed by optic nerve abnormality and ocular misalignment.Surgery for exotropia resulted in cosmetic improvement but no stereopsis. There is a possibility that better outcome would have been achieved if the diagnosis and treatment could be made during infancy. We advocate early detection of periventricular leukomalacia and treatment of eye complications.