リウマチ性多発筋痛症によって引き起こされた眼合併症の1例

Ocular complications in a case of rheumatic polymyalgia

要約　目的：リウマチ性多発筋痛症（PMR）によって引き起こされた眼合併症の1例の報告。

症例：74歳女性が，左頭痛，左顔面，左頸部から肩の疼痛，両眼視力低下を自覚し受診した。

所見と経過：初診時の矯正視力は右0.4，左光覚弁で，両眼底に慢性中心性網脈絡膜炎様の所見を認め，MRIでは，両眼視神経周囲に高信号を認めた。赤沈の上昇，症状より，左眼視神経周囲炎と慢性中心性網脈絡膜炎が合併したPMRと診断した。ステロイドパルス療法を施行し，1か月後には右視力は不変であったが，左眼視力は0.03に改善した。

結論：重症な眼虚血症候群の際には，巨細胞動脈炎も念頭に置いてPMRなど全身疾患の精査が重要である。

Abstract　Purpose：To report a case of ocular complications caused by rheumatic polymyalgia（PMR）.

Case：A 74-year-old female presented with left temporal headache, left face pain, left neck to shoulder pain, and decreased left vision.

Findings and Clinical Course：Corrected visual acuity was 0.4 in the right eye and light perception in the left. Chronic central choroiditis-like findings were present in both fundus. MRI showed a high signal around the binocular optic nerve. The patient was diagnosed with PMR complicated by left optic nerve perineuritis and chronic central retinochoroiditis based on increased blood sedimentation and symptoms. After suteroid pulse therapy, right eye vision remained unchanged and left eye vision improved to 0.03 one month later.

Conclusion：In severe ocular ischemia, it is important to examine systemic diseases such as PMR with giant cell arteritis.