ボツリヌス治療中の本態性眼瞼痙攣患者のQOLとその影響因子

QOL survey of patients with essential blepharospasm during botulinum toxin treatment

要約　目的：兵庫医科大学病院眼科のボツリヌス（BTX）外来に通院中の本態性眼瞼痙攣患者（EB）のquality of life（QOL）と，その影響因子について調査する。

対象と方法：対象は2019年10月からの4か月間にBTX治療を1年以上継続しているEB患者のうち，The 25-item National Eye Institute Function Questionnaire（VFQ-25）によるQOL評価が可能であった例である。QOLの影響因子として，年齢，投与回数，治療期間，EBの程度，遮光眼鏡とBTX治療に対する満足度（5段階評価）の関与を，重回帰分析を用いて検討した。EBの程度判定はJankovic評価スケール（重症度＋頻度：0〜8点）を用いた。

結果：EB患者58例（平均年齢69.4歳：39〜83歳，男性12例，女性46例）で検討を行ったところ，VFQ-25は45.7〜85.8点に分布し，年齢は心の健康と，治療期間は眼の痛みの軽減と正の相関を認めた。EBの程度は一般的見え方，心の健康，自立で負の相関を認めた。遮光眼鏡の満足度は，一般的見え方，目の痛みの軽減で正の相関を認め，BTX治療の満足度は自立，運転，色覚を除く9項目で正の相関を認めた。

結論：BTX治療の満足度がQOLの改善に最も関与していた。EBでは遮光眼鏡も併用し，BTX治療を長く続けられることが重要である。

Abstract　Purpose：To investigate the quality of life（QOL）and its associated factors in patients with essential blepharospasm（EB）who had visited the outpatient clinic for botulinum toxin（BTX）treatment at Hyogo College of Medicine Hospital.

Subjects and methods：Patients who were diagnosed with EB and treated with BTX for at least 1 year between October 2019 and January 2020 were recruited. The Visual Function Questionnaire（VFQ-25）was used to assess QOL. As factors affecting VFQ-25 score, age, number of BTX treatment, treatment duration, EB degree, and the satisfaction level of muffled glasses and BTX treatment（5-point scale）were analyzed by multiple regression analysis. EB severity was determined using the Jankovic scale（severity＋frequency：0-8 points）.

Results：Fifty-eight patients diagnosed with EB（mean age, 69.4 years；range 39-83 years；12 males and 46 females）were included. The VFQ-25 scores ranged from 45.7 to 85.8. Age was correlated with mental health, and treatment duration was positively correlated with reduced eye pain. EB severity was negatively correlated with general visual acuity, mental health, and independence. Satisfaction with the muffled glasses was correlated with general vision and reduced eye pain, satisfaction with the BTX treatment was positively correlated with all items, except for independence, driving, and color vision.

Conclusions：Satisfaction with the BTX treatment was the most important factor in improving QOL. It is important to patients with EB to continue the BTX treatment for a long term in combination with muffled glasses.