鼻性視神経炎に就ての考察

　緒言

　私は第35回総会（昭和27年5月）に於て「鼻性視神経炎に就て」といふ題下で今迄鼻性視神経炎は鼻腔副鼻腔の比較的変化の少ないものに多く，洞内の粘膜は病理組織学的に検索しなければその病的変化を見ることが出来ない程度のものであつてもしこの際視神経炎を治療する目的がなければ洞内開放の適応症のないものが多いのであつて，しかも手術後視力の回復を見ることによつて鼻性視神経炎と断定してきたのであるが，鼻腔副鼻腔以外の眼科的処置によつて球後視神経炎が多数治癒している事実があるのでこれを果して鼻性と云つてよいかどうか。又これ等の観点よりすれば従来考へられたような鼻性視神経炎なるものはよほど少なくなるのではないかと云ふことを述べたのであるがわづかな時間で充分に論述することが出来なかつたのでこゝに本誌をかりて一応詳しく述べさして貰つて諸君の御批判を乞ひたいと思ふのである。

YAMAMOTO reports 4 cases of optic neu-ritis which were successfully cured by a treament that employed reinjection of patients own blood in the soft tissues behind the eye-ball-a trea-tment which is at present commonly practiced among the ophthalomologists in general. Here-tofore, optic neuritis has been regarded as being caused byparanasal sinusitis and in majority of such cases catarrhal inflammation was found in the sinuses. When the sinuses were cleared by operation improvement of vision followed. But, when the disease is cured in this way by injecti-ng autogenous blood instead of operation on the sinuses its overall nasal origin becomes insecure, However, in some cases in whom the sinuses are definitely and markedly involved and in which improvement take place after adequate drainage of the sinuses the nasal origin of thedisease cannot be denied. With advent of the present method of treatment which serves in an extent a diagnostic acumen the findings of true nasal origin of the disease may de very small in number. The author regards those cases which respond to treatment without operation as manifestations of allergy. And whether that allergy is due to involvement of the eye or nose alone, or, based upon some other cause as that of tubercular infections are not clear. The answers fo these questions, the author says, must await further investigations.