Amiodarone Keratopathy

　1．Amiodaroneを長期投与中の難治性不整脈患者5名全例の両眼に角膜症の発現を認めた．

　2．角膜症以外に，明らかな眼科的異常所見を確認し得ず，また平均6カ月間の観察期間中に，視機能の低下を認めなかった．

　3．角膜症は，amiodaroneの総投与量が増すにつれて進行する傾向が見られた．

　4．涙液脂質濃度を測定した結果，角膜症を持つ患者群は，正常群よりも明らかに燐脂質の濃度が高く，涙液脂質濃度の上昇と角膜症発生・進行との間の因果関係が強く示唆された．

Keratopathy was recognised in all five patients who were under long-term treatment of systemic amiodarone for life-threatening arrhythmia. The deposits appeared as grayish to golden brown tinygranules beneath the corneal epithelium. No other ocular side effects were found over a follow-up period of 6 months or more. The patients were free of visual disturbances.

The keratopathy was apt to parallel the total cumulated dosis of systemic amiodarone. Through analysis of lipids in the tear fluid, phspholipid was detected in patients and not in control subjects. It appeared that an increase in lipids in the tear is causatively related to the pathogenesis of ker-atopathy.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(5) : 533-536, 1988