Transient Visual Loss in Posterior Reversible Encephalopathy Syndrome

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  • 可逆性白質脳症（PRES）により一過性視野障害を来した一例

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Posterior reversible encephalopathy syndrome(PRES)is transient cerebral edema, most often detected in the parieto-occipital region. The most common causes of PRES are hypertension and usage of immunosuppressant or anti-cancer drug.A55-year-old man with maxillary carcinoma underwent chemotherapy using cisplatin and 5FU. Hypertension and renal failure occurred after the therapy.One month after the remedy, he was suddenly aware of his visual disturbance. The corrected visual acuity in his both eyes decreased to 0.02. Fluid-attenuated inversion recorery magnetic resonance imaging(MRI)of the brain showed hyperintensity lesions in the bilateral occipital lobes,and he was diagnosed with PRES. Owing to intensive treatment including blood pressure control and brain edema treatment, his visual acuity was gradually improved and the MRI lesions disappeared. In this case, anti-cancer drugs caused endothelial damage and hypertension exacerbated the condition, caused vasogenic edema, leading to PRES.

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