東日本大震災前後のドライアイの変化

Changes in dry eye after the Great East Japan Earthquake

要約　目的：東日本大震災のため，仮設住宅生活を余儀なくされた被災者のドライアイ症状の変化の報告。対象と方法：2011年3月11日以前より気仙沼市立病院眼科に通院し，かつ震災で被災し，仮設住宅で生活することになったドライアイ患者30例を無作為に抽出した。ドライアイ症状の変化，治療経過についてレトロスペクティブに比較検討した。結果：自覚症状の悪化は17例（57％），不変は13例（43％），改善例はなかった。悪化した主な症状は眼乾燥感が47％，異物感が35％，霞みが12％，流涙が6％であった。症状が悪化した時期は震災から6か月以内が18％，6～12か月が53％，12～24か月が29％であった。震災後，新たな点眼の追加なく経過観察できた症例が41％，点眼の1剤追加が47％，2剤追加が12％であった。点眼を追加した10例すべてにジクアホソルナトリウムを追加しており，その後のドライアイ症状経過は改善が60％，不変が40％であった。結論：ドライアイ症状が悪化した原因は，主に心的外傷と環境ストレスが考えられた。震災後の継続的なストレス下では，数か月のタイムラグ後にドライアイが痛覚知覚に関連する症状が増加すると推測された。

Abstract.　Purpose：To report changes in clinical features of dry eye syndrome in persons who were forced to live in temporary housing after their houses were destroyed by the Great East Japan Earthquake on March 11, 2011. Cases and Method：This study was made on 30 patients who had been treated for dry eye before the earthquake at the Kesennuma City Hospital. These 30 cases were randomly selected and comprised 4 males and 26 females. The age averaged 71.9±9.9 years. They were followed up for 26 months after the earthquake. Results：Subjective symptoms became worse in 17 cases（57％）and remained unchanged in 13 cases（43％）. Out of these 17 cases, 8 cases complained of dry eye sensation, 6 cases reported pain of the eye, 2 cases reported haziness, and one cases showed increase in lacrimation. Subjective symptoms became worse within 6 months after the Earthquake in 3 cases, 6 to 12 months in 9 cases, and after 12 months in 5 cases. They were treated by the same topical medication as before in 41％, by adding another eyedrop in 47％, and adding two medications in 12％. All the 10 cases who received additional medication received diquafosol sodium. Symptoms improved in 6 cases and remained unchanged in 4 cases. Conclusion：Mental trauma and environmental stress seemed to be major causes for progression of symptoms after the Earthquake. Dry eye appeared to result in manifestations of symptoms related to sensation of pain after the time lag of a few months after the disaster.