多彩な眼所見を呈した内頸動脈閉塞症の1症例

Unilateral occlusion of internal carotid caused neovascular glaucoma and cherry red macula

　Cherry red spot，血管新生緑内障をはじめとする多彩な眼所見をきたした内頸動脈閉塞症の症例を報告した。症例は57歳男性で，右眼の霧視を主訴として来院したが，当初，眼科的な他覚所見を欠き，視力は日によって変動した。初診より1ヵ月後，右眼底に白斑を生じ，隅角に周辺部虹彩前癒着が観察された。初診より2ヵ月後急激な視力低下と眼圧上昇をきたし，右眼底のCherry　red spotと血管新生緑内障の所見が観察された。頸動脈造影の結果，右内頸動脈完全閉塞が発見され，それまでにみられた眼症状は内頸動脈閉塞症に起因する眼動脈領域の慢性阻血の結果と判断された。

A 57-year-old man presented with blurred vision in his right eye. The visual acuity fluctuated between 0.1 and 0.7. funduscopy showed normal appearance. We suspected dysfunction in the right optic nerve on account of central depression in static perimetry, moderate dyschromatopsia, de-creased critical flicker fusion frequency and rela-tive afferent pupillary defect. One month later, he developed cotton-wool spots and peripheral ante-rior synechia in his right eye. Another month later, he noticed acute visual loss and pain in his right eye. He manifested cherry red macula and aboli-shed a and b waved on ERG. Fluorescein angiogra-phy suggested severe circulatory disturbance in the retinal and choroidal arteries. Consequent carotid arteriography showed completely occluded right internal carotid as the underlying cause for the ocular manifestations.