アカントアメーバ角膜炎に対する副腎皮質ステロイド薬投与の影響

Influence of systemic corticosteroid on Acanthamoeba keratitis

要約　目的：診断確定前の副腎皮質ステロイド投与がアカントアメーバ角膜炎に及ぼす影響の報告。対象：過去47か月間にアカントアメーバ角膜炎と診断治療した10例10眼を対象とした。男性6例，女性4例で，年齢は16～73歳，平均29歳であった。結果：診断確定前に3例に副腎皮質ステロイドが投与されていた。うち2例は移行期，1例は完成期であった。非投与群は7例で，すべて初期であった。最終視力は非投与群で良好であり，治療期間は投与群が非投与群よりも長かった。結論：診断が確定する前の副腎皮質ステロイド投与は，アカントアメーバ角膜炎を悪化または長期化させる可能性がある。

Abstract.　Purpose：To report the influence of systemic corticosteroid on Acanthamoeba keratitis before definite diagnosis. Cases：This retrospective study was made on 10 eyes of 10 cases of Acanthamoeba keratitis during the foregoing 47 months. The series comprised 6 males and 4 females. The age ranged from 16 to 73 years,average 29 years. Results：Three cases were given systemic corticosteroid before definite diagnosis. Two of the 3 cases were in the transition stage and one was in the established stage. Seven cases who were given no corticosteroid were in the early stage of disease. Final visual acuity was better in cases who received no corticosteroid. Treatment lasted longer in cases who were given corticosteroid. Conclusion：Systemic corticosteroid prior to definite diagnosis of Acanthamoeba keratitis may result in poor visual outcome and prolonged treatment.