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Rinsho Ganka Volume 40, Issue 5 （May 1986）

臨床眼科 40巻5号（1986年5月発行）

Japanese English

特集第39回日本臨床眼科学会講演集　（4）

学会原著

原田病の視機能の予後についての検討　ステロイド大量投与例と非投与例の比較 Visual prognosis in Harada's disease. A revaluation of massive systemic corticosteroid therapy 山本倬司 ¹ , 佐々木隆敏 ¹ , 斉藤春和 ¹ , 磯部裕 ¹ , 新納昭子 ¹ , 若林紀子 ¹ , 木村素子 ¹ Takuji Yamamoto ¹ , Takatoshi Sasaki ¹ , Harukazu Saito ¹ , Yutaka Isobe ¹ , Akiko Niino ¹ , Noriko Wakabayashi ¹ , Motoko Kimura ¹ ¹横浜市立大学医学部眼科学教室 ¹Dept. of Ophthalmol, Yokohama City Univ Sch of Med pp.461-464

発行日 1986年5月15日 Published Date 1986/5/15

DOI https://doi.org/10.11477/mf.1410209704

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Abstract 文献概要
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　原田病のステロイド大量療法の評価を再検討することを目的とし，ステロイド大量投与例（A群）と非投与例（B群）を対象として，その視機能の予後について検討した．初診より6カ月以上観察できた症例30例59眼（A群13例26眼，B群17例33眼）を対象とし，次の各視機能につき検査を行った．検査成績：1）視力：1.0以上はA群76％，B群94％．0.5以下はA群16％，B群0．2）色覚；a）40色相配列検査，総偏差点25以下はA群81％，B群70％．26以上はA群19％，B群30％．b） SPP II，青黄異常はA群23％，B群31％．赤緑異常はA群12％，B群13％．3）視野：異常はA,B群とも27％．4） CFF：異常値を示したものA,B群とも27％．5） ERG：低下したものA群38％，B群33％．6）暗順応：低下したものA群39％，B群12％であった．A群，B群の視機能の予後にはほとんど差がなく，また良好な経過をとった．このことから画一的なステロイド大量療法は行われるべきでないと考える．

We evaluated the validity of massive systemic cor-ticosteroid therapy in Harada's disease which is cur-rently held to be the most effective therapeutic modality for this condition. Our study was based on two groups of patients with this disease. Group A consisted of a consecutive series of 13 cases (26 eyes) who were treated with massive corticosteroid. Group B consisted of another consecutive series of 17 cases (33 eyes) treated by conventional method and without systemic corticosteroid. All the cases were followed up for at least 6 months.

As the final outcome, visual acuity level of 20/20 was obtained in 73% of cases in Group A and in 94% in Group B. Visual acuity was 10/20 or less in 16% of cases in Group A and in none in Group B. Color vision tests with 40-hue arrangement method showed a total devia-tion of 25 points or less in 81% in Group A and in 70% in Group B. Color vision tests with SPP II showed abnormality in blue and yellow range in 23% of cases in Group A and in 31% in Group B. Abnormality in the red-green category was detected in 12% in Group A and in 13% in B. Abnormal visual field was detected in 27% in A and in 27% in B. Critical flicker fusion frequency (CFF) was abnormal in 27% each in Group A and B. Electroretiongram (ERG) was found to be abnormal in 38% in A and in 33% in B. Dark adaptation was abnor-mal in 39% in A and in 12% in B.

Above findings indicate that there exists virtually no difference in the prognosis as to visual function between the two groups. We reject the theory that all cases with Harada's disease are to be treated with massive sys-temic corticosteroid.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(5) : 461-464, 1986