急激な眼圧上昇，近視下，および眼軸長の伸長を認めたステロイド緑内障の1例

Acute ocular hypertension in a patient with steroid induced glaucoma followed by acute myopia and the elongation of axial length

　23歳のステロイド緑内障の症例に，急激な眼圧上昇と弱主経線屈折力にして-5.5Dの片眼性の急性近視が生じた。水晶体厚の有意な増大と浅前房及び硝子体長の延長には，ピロカルピン点眼，D—マンニトールおよびメタゾラミド投与の影響が考えられた。眼圧上昇の著明な右眼に，角膜曲率半径の減少と眼軸長・硝子体長の延長があった。右眼に対する線維柱帯切除術とD—マンニトールおよびメタゾラミドの中止後，眼圧低下とともに近視は約4か月で-0.75Dに回復し，角膜曲率半径は有意に減少した。本症例は抗緑内障薬による近視化に加え，急激に眼圧が上昇した片眼に角膜突出と眼軸長の延長が生じた一過性近視が特徴であった。

This report describes a case of transient myopia of approximately 5.5 diopters, associated with acute intraocular hypertension induced by oralclysis of prednisolone in a 23-year-old patient with steroid-induced glaucoma. A thickened lens and decreased anterior chamber depth were observed to significant degrees, which seemed to be an effect of pilocarpine, mannitol, and methazolamide therapy. Decreased radius of curvature at the vertex corneae and elongation of the internal axial and vitreous length were observed in the right eye with ocular hypertension. After traculectomy for the right eye and cessation of mannitol and methazolamide therapy, the intraocular tension of the right eye decreased and the myopia was improved to 0.75 diopters. An increase in the radius of corneal curvature and a decrease in the refractive power of the cornea, the lens thickness, the axial length, and the vitreous length were also observed to a significant degrees. This is a new observation of transient myopia with thickened lens and shallow anterior chamber caused by antiglaucomatic agents, and decreased radius of corneal curvature and the elongation of the axial and vitreous length caused by ocular hypertension.