Uhthoff現象を呈したシンナー中毒による視神経症の1例

Optic neuropathy with Uhthoff phenomenon in a habitual glue sniffer

　数年来のシンナー吸入歴をもつ21歳男性が1日100mlという多量のシンナーを7日間吸入し続けた結果，意識障害，失調，構音障害を伴う急性シンナー中毒になり著明な視力低下を来し明暗の認識も不能になった．シンナー吸入中止により視力は1.0まで回復し視野の初期の中心暗点が消失したかにみえたが，その後も長期にわたってシンナー吸入をくりかえしたため，慢性シンナー中毒になり視力低下，視野で傍中心比較暗点の出現にくわえてUhthoff現象を呈するに至り，さらに眼底所見で視神経の萎縮を来した．

　これはシンナー中のトルエンにより視神経の髄鞘の変性と崩壊を生じた結果であろうと推論した．

A 21-year-old male, who was a habitual sniffer of glue for several years, suddenly lost his vision after inhaling solvent for paint, roughly 100ml per day for a week. Normal visual acuity recovered spontaneously 2 months later.

During the course of recovery, central scotoma was present at first. Relative central and paracentral scotomas still persisted 1 year after the attack.

During the convalescent period of visual field, we observed Uhthoff phenomenon followed by repeatedattacks of transient visual blurring and relative scotoma.

The observed clinical features were interpreted as manifestations of optic nerve damage due probably to toluene in the inhaled solvent for paint.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(4) : 547-551, 1986