鼻側階段状視野欠損をきたした内頸動脈瘤の1例

Nasal step field defect in a case of aneurysm of internal carotid artery

要約　目的：鼻側階段状視野欠損で初発した内頸動脈瘤の症例の報告。症例：61歳女性が鼻側階段状視野欠損で紹介受診した。31か月前に眼精疲労で近医を受診し，視力は正常であった。19か月前に乳頭の蒼白化があり，視力と視野は正常であった。所見：矯正視力は右0.5，左1.5で，眼圧は正常，乳頭の陥凹/乳頭比は右0.7，左0.4であった。Goldmann視野で右眼に上鼻側階段状視野欠損があった。初診の2か月後に行った頭部の単純CTで右内頸動脈瘤が発見され，動脈瘤コイル塞栓術が行われ，以後9か月後の現在まで視機能は維持され，経過は良好である。結論：鼻側階段状視野欠損を初発症状として内頸動脈瘤が発症することがある。

Abstract.　Purpose：To report a case of aneurysm of internal carotid artery with nasal step visual field defect as the initial manifestation. Case：A 61-year-old female was referred to us for nasal step visual field defect. She had had normal visual acuity when seen by an ophthalmologist for eye strain 31 months before. Pallor of right optic disc had been found 19 months before with normal visual field and acuity. Findings：Corrected visual acuity was 0.5 right and 1.5 left. Intraocular pressure was within normal limits. Goldmann perimetry showed upper nasal step field defect in the right eye. Aneurysm of internal carotid artery was found by computed tomography of the head 2 months later. She received embolization of the aneurysm. She has been doing well with well-preserved visual function for 9 months until present. Conclusion：This case illustrates that aneurysm of internal carotid may manifest nasal step visual field defect as the initial manifestation.