原発緑内障の失明統計

Survey of blindness in primary glaucomas

　1967年より1986年までの過去約20年間に，当院緑内障カルテに登録された3,295例を対象として，緑内障の病型別失明統計を行った．失明は矯正視力0.01以下と定義した．このうち緑内障の疑い640例と高眼圧症172例を除くと2,483例であった．初診時失明は544例，622眼（25.1％），経過中の失明は，70例71眼（2.9％）であった．

　急性閉塞隅角緑内障による初診時失明率は50.4％と最も高率であり，眼科管理の遅れが注目された．失明率は発育緑内障，原発開放隅角緑内障，低眼圧緑内障，阻血性視神経症の順に10.0％，7.4％，5.5％，3.1％であった．眼圧コントロールの問題が最も大きいものと考えられた．

　経過中失明したものが71眼あり，そのうち5眼（7％）は眼圧コントロール良好でありながら失明に至っていた．このうち3眼には著明な耳側コーヌスがあり，素因的な視神経の脆弱性の問題が背景にあることが推察された．

We surveyed the incidence of blindness based on the clinical record of 3,295 cases with glaucoma seen by us during the foregoing 20 years through 1986. The series included 2,483 cases with glau-coma, 640 glaucoma suspects and 172 ocular hyper-tension. Blindness was defined as visual acuity less than 0.01. The incidence of blindness at the first visit was 21.9 % (544/2483). It was 2.8 % (70/2483) during the course of follow up.

Acute angle-closure glaucoma presented with thehighest incidence (50.4 %) of blindness at the first visit. The incidence of blindness was 10.0 % in developmental glaucoma, 7.4 % in primary open -angle glaucoma, 5.5 % in low tension glaucoma, and 3.1 % in chronic ischemic optic atrophy. During the course of follow up, 17 of 71 eyes became blind because of failure in control of intraocular pressure. Further 5 eyes became blind in spite of good control of intraocular pressure. These 5 eyes included three which presented remarkable temporal conus.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(9) : 1045-1049, 1988