両眼同時に発症した前部虚血性視神経症の1例

A case of anterior ischemic optic neuropathy with simultaneous onset in both eyes

　両眼同時に前部虚血性視神経症（anterior ischemic optic neuropathy：AION）を発症した血液透析中の症例を経験した。症例は65歳女性で，52歳から慢性腎不全のため血液透析を受けていた。血液透析後に血管造影を受けたところ，血圧が60／40に低下した。その翌々日の起床時に両眼の霧視を自覚し，眼科を受診した。視力は両眼とも指数弁。視野，フリッカー値は測定不能であった。両眼とも，視神経乳頭は蒼白浮腫状で，螢光眼底造影では，両眼の乳頭から螢光色素の漏出がみられた。長期にわたる血液透析と，血管造影後の血圧低下が，AION発症の原因と考えた。

A 65-year-old female had been under hemodialysis for chronic renal failure since 13 years before. Acute systemic hypotension, measuring 60/40mmHg, developed immediately after angiography following hemodialysis. Two days later, she noted blurring of vision in both eyes. When seen by us the following day, the visual acuity was counting fingers in both eyes. Funduscopy showed pale and edematous optic disc. Fluorescein angiography showed extravasation of dye from the disc in both eyes. She was diagnosed as anterior ischemic optic neuropathy in both eyes. Longterm hemodialysis and systemic hypoten-sion following angiography appeared to have induced the optic nerve lesions.