原因不明の視神経炎（症）のステロイド治療成績92眼の解析

Value of systemic corticosteroid in 92 eyes with idiopathic optic neuropathy

　原因不明の視神経炎（症）64例92眼を対象としてステロイド治療の効果を視力を指標にretrospectiveに検討した．平均年齢は31.0歳，平均観察期間は12.0カ月である．視力0.1未満は初診時57.6％，最悪時66.3％であった．回復過程で1カ月時点では0.8以上の視力は58.7％，最終時では72.8％であった．また，0.1未満にとどまったものは92眼中10眼10.9％であった．

　ステロイド1カ月投与量および総投与量とも視力の回復率には関係がなかった．初発症状よりステロイド投与開始までの期間が長いほど視力の回復が悪く，また視力回復まで長期間かかった．当科における原因不明の視神経炎（症）でのステロイド総使用量はプレドニソロン換算1,000mg以下，期間は2カ月以下であることが明らかとなった．

We retrospectively evaluated a consecutive series of 64 patients, 92 eyes, with optic neuritis or neur-opathy of unidentified etiology treated by systemic corticosteroid preparations. The ages of the patients averaged 31 years. The cases were fol-lowed up for an average period of 12 months.

The visual acuity was 0.1 or less in 58% of the eyes when initially seen and in 66% of the eyes some time during the whole course of the disease. Visual acuity was 0.8 or better in 59% of the cases at the end of the first one month of treatment andin 73% when seen finally. A total of 10 eyes (11%) remained with visual acuity under 0.1.

We detected no correlation between the visual acuity on the one hand and the total dosis of cor-ticosteroid or the period on the other. As a general rule, recovery of vision was less prompt and less favorable parallel to the interval between onset of the disease and initiation of corticosteroid therapy. The total dosis of corticosteroid in the present series was less than 1,000 mg prednisolone equiva-lent over a period of 2 months or less.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(3) : 238-241, 1988