血液透析中にのみ高眼圧を認めた開放隅角緑内障の1症例

A case of open angle glaucoma manifested episodes of ocular hypertension during hemodialysis

　多発性筋炎に対して過去8年間ステロイド剤の全身投与を受けていた54歳女性が，1年前に急性腎障害を発症した。血液透析または血液濾過の最中にのみ高眼圧状態になった。透析・濾過の開始と共に眼圧が上昇した。血液濾過よりも透析のほうが眼圧上昇幅が大きかった。眼圧上昇時の房水流出率は眼圧正常時と差がなく，本症での眼圧上昇は，血漿と房水との浸透圧差による房水量の増加が原因と推定された。

A 54-year-old female had been treated with systemic prednisolone for polymyositis during the foregoing 8 years. Cataract surgery with iridectomy had been performed for both eyes. Acute renal failure developed one year ago. Transient elevation of intraocular pressure repeatedly set in duringhemodialysis and, to a lesser degree, during hemofiltration. At each episode, the intraocular pressure rose immediately after start of hemodialysis or hemofiltration. The coefficient of aqueous outflow remained the same before, during or after hemodialysis. The observed rise in intraocular pressure appeared to be due to in-creased volume of the aqueous secondary to differ-ences in osmolarity between the plasma and the aqueous.