Dysthyroid optic neuropathyに対するplasmapheresisおよびsteroid併用療法の有効性

Combined plasmapheresis and corticosteroid therapy for dysthyroid optic neuropathy

　眼球突出で初発し，その後眼球突出増悪し視力，視野障害を併発したdysthyroidoptic neuropathy （DON）の3症例を経験した．これらに対してsteroid療法を行ったが効果なく，plasmapheresis （PP）とprednisolone大量療法を併用したところ全例に視力・視野の著明な改善がみられた．眼球突出に関しては6眼中3眼に改善がみられたが3眼は回復しなかった．しかし，CT像では外眼筋の肥厚は著明に減少していた．

　DONの治療としてPPとsteroid併用療法は極めて有効性が高い治療法と思われる．

We treated 3 cases with dysthyroid optic neuro-pathy due to Graves' disease using systemic predni-solone and repeated plasmapheresis. In the five affect-ed eyes, central scotoma was present with the visual acuity reduced to less than 0.1 in 3 eyes. Cortico-steroid treatment proved futile in the 3 cases.

The combined treatment with systemic steroid and plasmapheresis was effective in all the cases as regards recovery of visual acuity and visual field. The bene-ficial effect became manifest promptly after a few therapeutic courses. A reduction in hypertrophy of extraocular muscles resulted in one case when seen on CT scanning.