遷延性原田病のステロイド治療経過中に角膜穿孔をきたした1症例

Corneal perforation in a case of protracted Vogt-Koyanagi-Harada disease under corticosteroid therapy

　現在66歳の男性が，30歳のときに原田病を発症した。炎症が遷延し，ステロイド薬の内服と点眼を続けていた。51歳で右眼白内障手術を受けた。61歳のときに角膜潰瘍が生じ，角膜びらんを繰り返して角膜中央部が菲薄化した。64歳でデスメ膜瘤が生じ，角膜が穿孔したので全層角膜移植を行った。角膜菲薄化の原因として，長期のステロイド薬の点眼による副作用，ドライアイによる薬剤毒性の増強などが考えられた。

A now 66-year-old male had developed Vogt-Koyanagi-Harada disease at the age of 30 years. He had been treated, thereafter, by systemic and topical corticosteroid for protracted intraocular inflammation. Cataract surgery was performed in the right eye at the age of 51 years. Corneal ulcer developed at the age of 61 years followed by recurrent corneal erosion and thinning of the central cornea. He underwent penetrating keratoplasty at the age of 64 years for descemetocele with corneal perforation. It appeared that the corneal thinning was induced by prolonged use of corticosteroid and enhanced susceptibility to the drug due to dry eye condition.