ステロイドパルス療法が著効した難治性後部強膜炎の2例

Corticosteroid pulse therapy was effective in two cases of refractory posterior scleritis

要約　目的：難治性の後部強膜炎に対し，ステロイドパルス療法が奏効した2症例の報告。症例：1例は58歳女性。両眼に前部強膜炎と反復性の虹彩炎が生じた。ステロイド薬の内服と局所投与で軽快せず，1年後に右眼の乳頭浮腫と左眼のぶどう膜炎が発症した。メチルプレドニゾロンのパルス療法で寛解した。第2例は76歳女性。1年前に発症した左眼の後部強膜炎と胞状網膜剝離で受診した。メチルプレドニゾロンのパルス療法で軽快した。6か月後と13か月後に再発した後部強膜炎と網膜剝離に，同療法が奏効し，寛解を得た。結論：重篤な眼合併症が併発した後部強膜炎の2例にメチルプレドニゾロンのパルス療法が奏効した。

Abstract.　Purpose：To report two cases of refractory posterior scleritis that responded to steroid pulse therapy. Cases：The first case was a 58-year-old woman. She developed anterior scleritis and recurrent iritis in both eyes that failed to respond to topical and systemic corticosteroid. She showed papilledema in the right eye and uveitis in the left one year later. Methylprednisolone pulse therapy was followed by resolution. The second case was a 76-year-old woman. The left eye showed posterior scleritis with bullous retinal detachment since one year before. Methylprednisolone pulse therapy was followed by temporary resolution. Recurrence 6 and 13 months later was effectively treated by similar therapy. Conclusion：Methylprednisolone pulse therapy was effective in two cases of refractory posterior scleritis.