半側網膜中心動脈閉塞症を呈したもやもや病の1例

Hemispherical central retinal artery occlusion in a case of moyamoya disease

要約　目的：基礎疾患のない若年女性の片眼の半側網膜中心動脈閉塞症の経過観察中にもやもや病が発見された症例の報告。症例：28歳の女性が左眼上半分の視野欠損で受診した。所見：矯正視力は右1.2，左0.01（矯正不能）で，左眼に網膜中心動脈閉塞症の所見を認めた。頭部磁気共鳴血管造影でもやもや病が発見され，血管造影検査にて左網膜動脈の描出は不良であった。点滴治療・高圧酸素療法などを施行し，視力，視野ともに改善した。結論：若年者の網膜中心動脈閉塞症では，もやもや病のような血管異常をきたす疾患の合併を考慮する必要がある。

Abstract.　Purpose：To report hemispherical central retinal artery occlusion in an apparently healthy woman with moyamoya disease. Case：A 28-year-old female presented with sudden visual field defect in her left eye since a few hours before. Findings：Corrected visual acuity was 1.2 right and 0.01 left. The left eye showed occlusion of central retinal artery in the inferior hemisphere. Magnetic resonance angiography（MRA）showed moyamoya vessels that formed by collateral vascular network at the terminal portions of internal carotid arteries. Cerebral angiography showed indistinct retinal artery. Pharmacotherapy with hyperbaric oxygen was followed by improved visual field and visual acuity. She expired 3 months later by cerebral complications. Conclusion：This case illustrates that extracranial vessels, including central retinal artery, may be involved in moyamoya disease.