多施設による緑内障患者の実態調査―正常眼圧緑内障と原発開放隅角緑内障

Current status of primary open-angle and normal-tension glaucoma in multiple institutions

要約　目的：眼科病院または診療所に通院中の緑内障患者について行った治療状況の報告。対象と方法：23施設に通院中の緑内障または高眼圧患者1,935例を調査し，特に原発開放隅角緑内障（POAG）と正常眼圧緑内障（NTG）の薬物治療の違いを検討した。結果：男性768例，女性1,167例で，年齢は9～102歳（平均67歳）であった。POAGが34.4％，NTGが47.4％で，全症例の80％以上が開放隅角であった。薬剤数の平均は，POAGが1.9±1.1剤，NTGが1.4±0.8剤で，前者が有意に多かった。単剤使用例では，両群ともラタノプロストが最も多く，POAGではチモロール，NTGではイソプロピルウノプロストンが有意に多かった。2剤使用例では，両群ともラタノプロストとβ遮断薬の併用が多かった。ラタノプロストとチモロールの併用は，NTGよりもPOAGで有意に多かった。結論：緑内障に対する薬物治療では，POAGでは眼圧下降，NTGでは眼内循環改善が重視されている。

Abstract.　Purpose：To report the outcome of survey on glaucoma patients treated by multiple institutions. Cases and Method：This survey was made on 1,935 patients who were treated for glaucoma or ocular hypertension by 23 institutions. Particular attention was paid to difference in medication between primary open-angle glaucoma（POAG）and normal-tension glaucoma（NTG）. Results：The present series comprised 768 males and 1,167 females. The age ranged from 9 to 102 years,average 67 years. More than 80％ of cases had open angle. POAG comprised 34.4％ and NTG 47.4％ of the whole series. POAG patients were receiving an average of 1.9±1.1 and NTG 1.4±0.8 medications. The difference was significant. Latanoprost was the most frequent agent as monotherapy for POAG and NTG. Timolol was more frequently used for POAG and isopropylunoproston for NTG. Combination of latanoprost and beta-blocker was more frequently used for POAG and NTG receiving dual medications. Combination of latanoprost and timolol was more frequent in POAG than NTG patients. Conclusion：Control of intraocular pressure is the main goal of treatment for POAG,while improvement of intraocular circulation is attempted for NTG.