視野障害様式で分類された高度近視を伴う緑内障眼のdynamic contour tonometerでの眼圧

Intraocular pressure measured by dynamic contour tonometer in eyes with high myopia and glaucoma as classified according to defective visual field pattern

要約　目的：高度近視がある緑内障眼での眼圧，視野，薬物の効果の報告。対象と方法：視野障害がある原発開放隅角緑内障または正常眼圧緑内障31例38眼を対象とした。全例が－6D以上の近視または26mm以上の眼軸長であった。上方視野障害が23眼，下方視野障害が15眼にあった。眼圧は圧平眼圧計とdynamic contour tonometer（DCT）で測定し，ラタノプロストとチモロール点眼による反応を両群で比較した。結果：眼圧は上方視野障害群で有意に高かった。平均眼圧はラタノプロスト点眼により両群で有意に下降した。チモロールの眼圧下降効果はラタノプロストよりも少なく，上方視野障害群でのDCTによる測定のみで有意であった。結論：DCTでは低眼圧領域での眼圧管理に有用である。高度近視がある緑内障ではチモロール点眼による眼圧下降効果が限られ，上方視野に障害があるときに第二選択となる。

Abstract.　Purpose：To report the intraocular pressure（IOP）,visual field and effect of topical medication in eyes with glaucoma and high myopia. Cases and Method：This study was made on 38 eyes of 31 cases with primary open-angle glaucoma or normal-tension glaucoma. All had myopia greater than －6 diopters or axial length greater than 26 mm. Visual field defect was present in the superior hemisphere in 23 eyes and in the inferior in 15 eyes. IOP was measured by applanation and by dynamic contour tonometer（DCT）. IOP in both groups were evaluated following instillation of latanoprost and timolol. Results：IOP was significantly higher in eyes with visual field defect in the superior hemisphere. IOP significantly decreased in both groups after instillation of latanoprost. Hypotensive effect of timolol was less than latanoprost and was significant only when measured by DCT. Conclusion：DCT is useful in the management of glaucoma with IOP in the lower range. Effect of timolol is limited in eyes with high myopia. Timolol is indicated as a second choice in eyes with visual field defect in the superior hemisphere.