抗緑内障点眼薬と角膜上皮障害

Superficial punctate keratopathy during topical treatment for glaucoma

要約　目的：点眼で治療中の緑内障患者での点状表層角膜症の報告。対象と方法：当院に通院中の緑内障患者486人882眼を対象とした。角膜をフルオレセインで染色して点状表層角膜症の有無を観察し，程度にはAD分類を用いた。結果：419眼（47.5％）に点状表層角膜症があった。その重篤度と頻度は，1日の点眼回数と使用している薬剤数に有意の相関があった（p＜0.01）。ラタノプロストまたはトラボプロストの単剤点眼では，角膜症の頻度に差がなかった。70歳未満に比べ，70歳以上では点状表層角膜症の頻度が増加したが，後者では点眼回数と使用薬剤数が多かった。結論：点眼治療中の緑内障眼の約48％に点状表層角膜症があり，その頻度と重篤度は1日の点眼回数と使用している薬剤数と正の相関があった。

Abstract.　Purpose：To report the incidence and severity of superficial punctate keratopathy（SPK）in patients treated by topical medication for glaucoma. Cases and Method：This study was made on 882 eyes of 486 glaucoma patients attending an eye clinic. The cornea was examined after staining by fluorescein. Severity of SPK was graded after AD classification. Results：SPK was present in 419 eyes（47.5％）. Its incidence and severity were positively correlated with the frequency of instillation and the number of medications（p＜0.01）. There was no difference in the incidence between eyes treated by latanoprost and by travoprost. Incidence of SPK was greater in patients aged 70 years or over than in those under 70 years of age. The former group was treated by larger number of medications and by more frequent instillation. Conclusion：SPK was present in about 48％ of eyes treated by topical medication for glaucoma. Its incidence and severity were positively correlated with the frequency of instillation and the number of medications.