ステロイド白内障発症要因の検討

Contributing factors for steroid cataract

（24E-5）　長崎大学医学部附属病院の他科で副腎皮質ステロイド薬（ステロイド）の全身投与を受け，その副作用の精査目的で眼科を紹介された44例88眼の白内障発症要因の検討を行った。白内障発症例と非発症例を比較すると，年間平均投与量は白内障発症例が有意に多かった。腎移植例と若年例では，より少ない総投与量，短い投与期間で発症した。全身合併疾患はステロイドの副作用によるものが高率で，ステロイド白内障発症群にステロイドによる全身合併症も多くみられた。ステロイド白内障の予防には，期間あたりのステロイド投与量に注意する必要があると考えられた。ステロイド白内障が生じた症例では，他の全身合併症の発症に，より一層注意が必要である。

We reviewed 44 patients who developed steroid cataract after systemic corticosteroid treatments. Those who developed cataract had received an average of 7,072 mg of prednisolone equivalent per year. No cataract had developed when receiving 4,405 mg per year. The steroid cataract was thus positively correlated with the average annual dosis of corticosteroid. Cataract developed earlier or after lower doses of corticosteroid in patients aged 20 years or under and in those after renal transplantation. The total dosis of corticosteroid averaged 8,822 mg of prednisolone equivalent in patients after renal transplantation and 23,928 mg in others. It averaged 9,181 mg in patients under 20 years and 46,050 mg in more aged patients. The duration of corticosteroid treatment was 20 months in patients after renal transplantation and in those aged 20 years or less. It averaged 59 months in those without renal transplantation and 116 months in those aged over 20 years.