上輪部角結膜炎（superior limbic keratoconjunctivitis）

Superior limbic keratoconjunctivitis in 8 cases

　superior limbic keratoconjunctivitis（SLK）は上輪部結膜を主体とする原因不明の慢性炎症疾患であるが本邦での報告は少ない．最近1年間に3施設の外来において男性2名，女性6名の計8名の患者がSLKと診断された．今回の結果では中高年の女性に多く見られ，1例に甲状腺機能異常を，5例に涙液減少症を伴っていた．一部の軽症例は硝酸銀の塗布に反応したが概して難治であり，ステロイド投与や病変の切除などは無効であった．こうした難治例にビタミンAを局所投与したところ，かなりの例で症状や所見の改善を見た．SLKは本邦でも決して稀な疾患ではなく，その特異な発生部位のために見過ごされている可能性が高いと考えられた．

Superior limbic keratoconjunctivitis (SLK) manifests chronic inflammation in the superior bulbar and tarsal conjunctiva. Its origin is unknown. It has been regarded as to be less common in Japan when compared with the Occident.

We observed 8 cases with SLK during the past one year. The cases included 2 males and 6 females of middle age. Thyroid dysfunction was present in one case and hypolacrimation in 5 cases. Bilateral occur-rence was the rule.

The lesion responded poorly to therapeutic measuresincluding application of 1% silver nitrate, topical ster-oid or surgical resection. Some cases showed improve-ment after topical instillation of vitamin A (retinal palmitate) ointment. SLK thus appears not to be a rare condition in Japan, as it may be overlooked due to its unique localization.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(9) : 1011-1015, 1986