日本医科大学多摩永山病院眼科における5年間の内眼炎患者の統計的観察

Epidemiologic study of intraocular inflammation patients across five years at a tertiary center in western Tokyo

要約　目的：日本医科大学多摩永山病院（以下，当院）の5年間の内眼炎患者の統計的観察および既報との比較。

対象と方法：2018年4月〜2023年3月に当院眼炎症外来を初診した内眼炎患者621例（男性248例，女性373例）を後方視的に診療録の観察研究を行った。

結果：初診時年齢は55.7±19.5歳。男性248例（39.9％），女性373例（60.1％）。強膜炎151例（24.3％），サルコイドーシス60例（9.7％），Vogt-小柳-原田病32例（5.2％），ヘルペス性角膜ぶどう膜炎32例（5.2％），ベーチェット病24例（3.9％），急性前部ぶどう膜炎22例（3.5％）の順に多く，31.2％は疾患カテゴリー分類不能であった。続発緑内障は238例（38.3％）で，そのうちステロイド緑内障は52例（21.8％）であった。生物学的製剤使用は43例（6.9％）で，そのうちアダリムマブ使用は27例（62.8％）であった。全国多施設眼炎症疾患統計（JJO 2021）と疾患頻度上位6疾患の内訳は一致していたが，本研究は強膜炎が最多であることが異なっていた。筆者らの既報（日眼会誌2015）と比べても，強膜炎が17.0％から24.3％に増え，続発緑内障の発生率も本研究が高かった。

結論：当院では他報告と比べて強膜炎が多く，続発緑内障の併発率も高かった。全体で生物学的製剤使用は7％弱であった。

Abstract　Purpose：To report the epidemiology of patients with intraocular inflammation at Nippon Medical School Tama Nagayama Hospital（NMS-TN）a tertiary center in western Tokyo, during the past five years, and to compare the results with those of a national multicenter study.

Methods：We retrospectively reviewed the medical records of 621 patients with intraocular inflammation who presented to the Ocular Inflammation Service at NMS-TN starting from April 2018.

Results：The averaged age was 55.7±19.5 years. There were 248 males（39.9％）and 373 females（60.1％）. The most frequent disease was scleritis in 151 cases（24.3％）, followed by sarcoidosis in 60 cases（9.7％）, Vogt-Koyanagi-Harada disease in 32 cases（5.2％）, herpetic uveitis in 32 cases（5.2％）, Behçet's disease in 24 cases（3.9％）, and acute anterior uveitis in 22 cases（3.5％）；31.2％ of the cases were unclassifiable. Secondary glaucoma occurred in 238 patients（38.3％）, of whom 52（21.8％）had steroid induced glaucoma. Biologics agents were used in 43 patients（6.9％）, of whom 27（62.8％）were treated with adalimumab. The top six most frequent diseases were consistent with the national multicenter ocular inflammatory disease statistics（JJO 2021）, but the present study differed in that scleritis was the most common disease. Compared to our previous report（JJO 2015）, the incidence of scleritis increased from 17.0％ to 24.3％, and the incidence of secondary glaucoma was also higher in our study.

Conclusion：Scleritis was remarkably common at the Ocular Inflammation Service in NMS-TN as patients were referred from all over the country, and the incidence of secondary glaucoma was about 40％. Overall, the prevalence of the use of biologic drugs was about 7％.