Churg-Strauss症候群に網膜動脈分枝閉塞症を合併した1例

Branch retinal artery occlusion in a case of Churg-Strauss syndrome

要約　背景：Churg-Strauss症候群では気管支喘息や好酸球増加が先行し，細動静脈から毛細血管を主座とする壊死性血管炎が全身に生じる。目的：Churg-Strauss症候群に網膜動脈分枝閉塞症が生じた報告。症例：42歳女性が1週間前からの左眼上方の視野異常で受診した。26歳のときから気管支喘息があり，最近Churg-Strauss症候群と診断され，内科でステロイドの投与を受けていた。所見：矯正視力は右1.2，左0.02で，左眼底の下耳側網膜動脈の支配範囲が白色化していた。左眼の網膜動脈分枝閉塞症と診断し，眼球マッサージ，前房穿刺，抗凝固療法，プレドニゾロン，免疫抑制薬の投与を行い，2週間後に視力が1.2に改善した。高血圧や糖尿病などの基礎疾患は否定された。結論：本症例では網膜動脈分枝閉塞症の発症にChurg-Strauss症候群が病因として関与した可能性がある。

Abstract.　Purpose：To report a case of Churg-Strauss syndrome who developed branch retinal artery occlusion. Case：A 42-year-old female presented with impaired visual field in the superior sector in her left eye since one week before. She had had bronchial asthma since 26 years of age. She was diagnosed with Churg-Strauss syndrome recently and was receiving corticosteroid. Findings：Corrected visual acuity was 1.2 right and 0.02 left. The left fundus showed opacity in the area supplied by superior temporal retinal artery. She was diagnosed with branch retinal artery occlusion and was treated by ocular massage,paracentesis,systemic anticoagulants,corticosteroid,and immunosuppressive agents. Visual acuity improved to 1.2 two weeks later. Conclusion：Churg-Strauss syndrome may have been pathogenetically involved with branch retinal artery occlusion in this patient.