レーザースペックル法により血流動態が確認できたAIONの1例

Laser speckle flowgraphy showed impaired hemodynamics in the fundus in a case of anterior ischemic optic neuropathy

　78歳の女性に左眼耳側の視朦が突発した。矯正視力は両眼とも1.0であり，左眼に比較的求心性瞳孔障害（RAPD）があった。左眼に乳頭面の鼻側と乳頭の鼻側網膜に蒼白浮腫があり，蛍光眼底造影で乳頭鼻側の脈絡膜に流入遅延があった。前部虚血性視神経症（AION）と診断した。レーザースペックル検査で蒼白浮腫のある部位に血流量の低下があり，経過とともに改善した。レーザースペックル検査は，AIONの診断と経過観察に有用であった。

A 78-year-old female presented with sudden temporal visual field defect in her left eye. Her corrected visual acuity was 1.0 in either eye. Relative afferent pupillary defect (RAPD) was present in her left eye. Funduscopy showed pale edema in the nasal half of the optic disc and in the temporal peripapillary retina. Fluorescein angiography showed retarded dye inflow in the temporal peripapillary choroid. These findings led to the diagnosis of anterior ischemic optic neuropathy (AION). Laser speckle flowgraphy showed decreased blood flow in the pale edematous fundus area which gradually improved later along with resolution of disc swelling. This case illustrates the usefulness of laser speckle flowgraphy in the diagnosis and follow-up of AION.