潰瘍性大腸炎患者に発症した視神経炎の1例

Optic neuritis in a patient of ulcerative colitis

　潰瘍性大腸炎患者に発症した視神経炎の1例を報告する。症例は50歳男性で，12年来，潰瘍性大腸炎にて副腎皮質ステロイド（ステロイド）治療中であり，内視鏡的には慢性持続型であった．視神経炎の発症前後を通して，全身状態の増悪はみられなかった。視神経炎の発症機序は不明であったが，ステロイド療法が奏効した。潰瘍性大腸炎症例に合併した視神経炎の報告は非常に稀であるが，原因不明の視神経炎をみた場合，潰瘍性大腸炎の存在も考慮すべきと考えられた。

A 50-year-old male had been treated by systemic corticosteroid for ulcerative colitis since 12 years before. The colitis was diagnosed as chronic continuous type by colonoscopy. His general condition was stable throughout. He developed severe loss of vision in both eyes 3 days before. When seen by us, the visual acuity was counting fingers right and no light perception left. He was diagnosed as acute optic neuritis. Massive corticosteroid therapy resulted in improvement of vision to 0.8 right and 0.2 left four months later. While the exact causative mechanism is not known, ulcerative colitis is a possibility in idiopathic acute optic neuritis.