原田病におけるステロイド療法の検討

Appraisal of corticosteroid treatment in Harada's disease

　北大眼科を受診した原田病患者の新鮮例37例を対象として，ステロイド療法における炎症の推移及び視力予後について比較検討を行った。ステロイド療法は，パルス療法群12例，大量投与群18例，全身投与を行わないで，局所のみの局所投与群7例の3群に分けられた。その結果，1．パルス療法群と大量投与群を合わせたステロイド剤大量全身投与群の方が，局所投与群よりも6ヵ月後の前房炎症が少なかった。2．パルス療法群と大量投与群を合わせたステロイド剤大量金身投与群の方が，局所投与群よりも最終視力が良好であった。3．ステロイド剤大量全身投与群のうちパルス療法群と大量投与群では，6ヵ月後の前房炎症，及び最終視力について差がないことがわかった。以上より，原田病において，ステロイド剤大量全身投与は有効な治療法であることが再確認された。

We evaluated the significance of systemic cor-ticosteroid in the treatment of Harada's disease during the initial phase of the disease. During the foregoing 4 years, we treated 37 cases of the dis-ease. The duration of the disease was less than 6 weeks and averaged 13 days before initiation of treatment.

The series was divided into 3 groups according to the mode of treatment. A group of 12 patients received systemic corticosteroid as 'pulse therapy', or steroid in mega dosis. Another group of 18 patients were treated with high-dose corticoster-oid, starting with prednisolone 200 mg per day. A third group 7 patients were treated without sys-temic corticosteroid. Topical corticosteroid was administered to all the cases in the series.

When evaluated 6 months after initiation of treatment, the inflammation in the anterior cham-ber was significantly less in the groups treated with systemic corticosteroid than in the group without. The final visual acuity was significantly better in the groups treated with systemic corticosteroid. There was no difference between the group treated by pulse therapy and by high-dose systemic cor-ticosteroid.

The findings are in support of systemic corticos-teroid in the treatment of Harada's disease during the initial phase.