網膜色素変性症と緑内障

Retinitis pigmentosa and glaucoma

　1984年12月までの3年間に関西医科大学眼科を受診した網膜色素変性症患者138例中，緑内障を合併したのは9例あった．その合併率は6.5％であり，全人口の緑内障発生率より約10倍の高頻度であった．

　緑内障は，原発性閉塞隅角緑内障6例，原発性開放隅角緑内障2例，続発性開放隅角緑内障1例であって，閉塞隅角縁内障の合併が特に高度であり，40歳代の比較的年齢の低いものにもみられた．

　眼圧正常な網膜色素変性症患者92例の前房隅角検査を行うと狭隅角が多い傾向があり，これが網膜色素変性症に閉塞隅角緑内障の合併が多い原因と思われた．

　網膜色素変性症に合併した緑内障の眼圧コントロールは薬物療法並びに手術療法で比較的容易にコントロールできた．

We observed 9 cases (6.5%) of glaucoma as an as-sociated lesion in a series of 138 cases with retinitis pigmentosa during the past 3 years. Above rate of glaucoma is roughly ten-fold that of glaucoma in the general population. The observed glaucoma was pri-mary angle closure glaucoma in 6 cases, simple glau-coma in 2 and secondary open angle glaucoma due to uveitis in one. The ages ranged from 35 to 69 years, average 52 years.

We evaluated the width of the anterior chamber angle in 92 cases with retinitis pigmentosa of ages 50 or less. These cases were free of glaucomas. The chamber angle was judged as Grade IV or III (Shaffer) in 81.5%, Grade II in 10.9% and Grade I in 7.6%. Thus, eyes with retinitis pigmentosa tended to manifest narrow angle more frequently than in general population. Glaucomas associated with retinitis pigmentosa were responsive to medical or surgical therapeutic approach in general.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40 (2) : 169-172, 1986