A 59-year-old man, who had a history of recurrent oral aphthous ulcer, was admitted to our hospital complaining of fever and decreased visual acuity, On admission his visual acuity was 0.04 in the right eye, and 0,06 in the left eye. Bilateral central scotoma was found by a Goldmann's visual field test. The patient also exhibited erythema on his extremities and aphthous ulcers on the oral mucosa and tongue. A serum and cerebrospinal fluid test showed an elevated inflammatory reaction with the further complication of aseptic meningitis. Fluorescein angiography revealed mild retinal angitis. A leukocyte HLA test was B51 positive. Lack of both anterior uveitis and macular degeneration suggested that the central scotoma was caused by optic neuropathy. Based on this data, a final diagnosis of Behçet disease with optic neuropathy and aseptic meningitis was made, Intravenous administration of methylprednisolone (1000 mg/day) was given for 3 days and was followed by a tapering administration of prednisolone (60 mg/day), which alleviated the general symptoms and improved visual acuity. Vasculitis, arachnoiditis around the optic chiasm, and the autoimmune reaction were suggestive pathomechanisms for the optic neuropathy.
|出版ステータス||Published - 06-2002|
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