アトピー性皮膚炎患者にみられたステロイド緑内障

Corticosteroid glaucoma in patients of atopic dermatitis

　アトピー性皮膚炎患者3名5眼に開放隅角緑内障が発症した。年齢はそれぞれ24歳，36歳，29歳であった。皮膚炎の加療歴はそれぞれ約20年，20年，14年であり，全例がステロイド薬軟膏，2例はステロイド薬内服を行っていた。2例では眼圧が当初は正常値であったが経過中に上昇し，1例では当初から高度に上昇していた。点眼により眼圧が下降しないため，5眼すべてに線維柱帯切開術を行い，眼圧が正常化した。アトピー性皮膚炎ではステロイド緑内障が起こることがあるので，定期的な眼科的管理が必要である。

We observed open-angle glaucoma in 5 eyes of 3 patients with atopic dermatitis. They were aged 24, 36 and 29 years respectively. They had been treated for atopic dermatitis for 20, 20 and 14 years respectively. All the cases had been treated with corticosteroid ointment. Two cases had received additional systemic corticosteroid. The intraocular pressure (IOP) was within normal limits in 2 cases but started to rise during the course of observation. One case had highly elevated IOP at the initial visit. After the IOP failed to respond to topical treatments, all the 5 eyes were successfully treated by trabeculotomy. These cases illustrate that steroid glaucoma is a liability in patients of atopic dermatitis and necessitates regular ophthalmological observation.