ドライアイ患者におけるピロカルピン塩酸塩服用中止後の眼所見

Ocular findings following discontinuation of oral pilocarpine in patients with dry eye

要約　目的：ドライアイ患者でのピロカルピン塩酸塩を内服中と内服中止後の眼所見の報告。症例：ドライアイに対してピロカルピン塩酸塩を内服し，なにかの理由で内服を中断した9例を対象とした。男性1例，女性8例で，年齢は53～72歳，平均60歳であった。内服は1日1回とし，その量は2例が2mg，7例が1mgであった。ドライアイは4例が涙液分泌減少型，5例が涙液蒸発亢進型であった。結果：涙液分泌量は内服中止前後で有意差はなかった。涙液層破壊時間（BUT）は両型とも中止後に短縮したが，治療開始前よりも有意に延長していた（p＝0.04，p＝0.02）。角結膜上皮障害スコアは涙液分泌減少型では中止後改善し（p＝0.01），涙液蒸発亢進型では変化がなかった。結論：ドライアイに対するピロカルピン塩酸塩内服は，内服中止後1か月間はドライアイを改善させる可能性がある。

Abstract.　Purpose：To report changes in ocular findings during and after discontinuation of peroral pilocarpine for dry eye. Cases：The present series comprised 9 patients who received peroral pilocarpine for dry eye and who failed to continue the treatment. The series comprised one male and 8 females. The age ranged from 53 to 72 years,average 60 years. Dry eye was classified as tear-deficient type in 4 cases and as evaporative in 5 cases. Two cases received pilocarpine at the daily dosis of 2 mg and 7 cases received 1 mg. Results：There was no significant change in the volume of tear secretion during and after treatment. Tear film break-up time became shorter after discontinuation in both types but was longer than before start of treatment（p＝0.04,p＝0.02）. Epithelial disorder score improved in cases of tear-deficient type（p＝0.01）after discontinuation and showed no change in cases of evaporative type. Conclusion：Dry eye may stay in improved state for one month after withdrawal of peroral pilocarpine.