糖尿病網膜症の修飾因子—Ⅱ．視神経萎縮

Modifying factors of diabetic retinopathy. Report 2. Optic atrophy

　片眼に視神経萎縮（以下萎縮）を合併した糖尿病網膜症患者（以下網膜症）9例18眼における，萎縮の網膜症抑制効果についてretrospec-tiveに検討した。萎縮の原因は，外傷性視神経症1例，前部虚血性視神経症4例，原因不明4例であった。このうち，萎縮が高度で，視野障害も比較的広範囲な5症例は萎縮側の網膜症が対眼より軽度で，萎縮による網膜症の抑制効果と思われた。しかし，萎縮が軽度であった残りの4例では網膜症に左右差は生じなかった。萎縮が網膜症を抑制するには，ゴールドマン視野で1／4以上の視野障害が生じる程度，視神経障害が高度になる必要性が示唆された。

We reviewed nine diabetic patients concerning the clinical features of diabetic retinopathy and unilateral optic atrophy. The optic atrophy was secondary to blunt trauma in 1, anterior ischemic optic neuropathy (AION) in 4 and idiopathic in 4. The visual field in the affected eye was contracted by one quandrant or more in the eye with traumatic atrophy, 3 with AION and 1 of unknown etiology. In these 5 cases, the diabetic retinopathy was lesssevere in the eye with optic atrophy. In the other 4 cases, the optic atrophy was mild with mere depres-sion of central sensitivity in the visual field. There was no differences in the severity of diabetic retinopathy in these 4 cases.

The findings suggest the possibility that the progression of diabetic retinopathy is inversely associated with the severity of optic atrophy.