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眼底検査時に,眼球の圧迫加減による網膜中心勤脈拍動状態の観察(眼球加圧テスト)で眼底血圧値の低下が疑われ,MR angiographyおよびdigital subtraction angiography (DSA)により,頸動脈狭窄症または閉塞症と診断された5例8眼について,その特徴を検討した。DSAで内頸動脈は60%以上狭窄していた。90%以上の狭窄例で螢光眼底検査上網膜内循環時間遅延がみられ,99%以上の高度狭窄例で網膜電図の律動小波が減弱していた。眼球加圧テストが内頸動脈狭窄症のスクリーニングとして有用であり,狭窄が高度の場合に眼底所見が軽微でも螢光眼底検査およびERGの所見が参考になると考えられた。
Funduscopy under compression of the eyeglobe, or digital ophthalmodynamometry, was used in detecting pathological decrease in the pressure of central retinal artery. Further detailed examinations in suspected cases led to the detection of stenosis or occlusion of the internal carotid artery in 8 eyes of 5 patients. By digital subtraction angiography (DSA) , the internal carotid artery showed stenosis by 60% or more in these cases. Fluorescein angiography showed prolonged arteriovenous transit time in cases with stenosis by more than 90%. Electroretinogram showed decreased amplitudes in oscillatory potentials in cases with stenosis by more than 99%. The findings show the value of digital ophthlamometry as a screening procedure for stenosis of internal carotid artery. Fluorescein angiography and electroretinogram are also useful in cases with pronounced stenosis even in apparently normal fundus appearance.
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