ステロイド内服が著効した網膜中心静脈閉塞症の1例

Peroral corticosteroid was effective in a case of central retinal vein occlusion

52歳女性の左眼に飛蚊症が突発し，即日受診した。矯正視力は左右眼とも1.0であった。左眼底に乳頭浮腫，網膜静脈の拡張と蛇行，網膜出血があった。非虚血型網膜中心静脈閉塞症の急性期と診断し，1日量81mgのアスピリン投与を開始した。1か月後に乳頭浮腫と網膜出血が増悪し，光干渉断層計（OCT）で網膜厚が増加していた。視力は不変であったが，虚血型への移行が疑われ1日量プレドニゾロン30mgを開始した。1週間後に網膜厚が減少し，2か月後に乳頭浮腫と網膜出血は消失した。副腎皮質ステロイド薬の全身投与が網膜循環悪化の防止に有効であったと推定される。

A 52-year-old female noted acute floaters in her left eye and sought medical advice the same day. Her corrected visual acuity was 1.0 in either eye. Her left fundus showed swelling of the optic disc,retinal hemorrhage,and dilated and tortuous retinal veins. She was diagnosed with acute nonischemic type of central retinal vein occlusion（CRVO）and started receiving aspirin at the dosis of 81 mg per day. Swelling of the disc and retina hemorrhage aggravated one month later. Optical coherence tomography（OCT）showed increase in retinal thickness. Her visual acuity remained unchanged. She was suspected with progression to ischemic CRVO and started receiving peroral prednisolone at the dosis of 30 mg per day. The retinal thickness started to decrease one week later. Disc swelling and retinal hemorrhage disappeared 2 months later. Systemic corticosteroid appeared to be useful in preventing aggravation of disturbed retinal circulation.