最近11年間における強膜炎75例の解析

Clinical features of 75 cases of scleritis during the past 11 years

　阪大眼科で最近11年間に観察された強膜炎患者75例について検討した．発症は30歳から70歳の年齢層に多く，平均45歳で，男女比は2：3であった．片眼性と両眼性の比率はほぼ1：1であり，この両者に重症度の差はなかった．病変は前部強膜で瞼裂に相当する部位に好発し，炎症は1年に1回程度の割合で再発していた．虹彩毛様体炎は片眼性39％，両眼性60％に合併し，その他の併発症は強膜菲薄化5例7眼，強膜ぶどう腫4例5眼，角膜病変6例8眼，眼圧上昇14例16眼，後部強膜炎による眼底病変12例15眼であった．視力の予後の良好なものが多かったが，併発症による重篤な視力低下をきたした例があった．強膜炎の治療にはステロイド剤が有効であるが，効果のあった投与法からみると点眼剤投与を主体として治療できる軽症例と内服の必要な重症例の2群に分かれる傾向があった．

We evaluated the clinical features of 75 cases of scleritis seen during the foregoing 11-year period. The ages at the initial onset of the disease ranged from the fourth to seventh decade, average 45 years. There were 30 males and 45 females. The disease occurred unilaterally or bilaterally at about the same incidence. There was no difference in the severity between unilateral and bilateral cases.

Typically, inflammatory reactions in the anterior sclera appeared twice in the initial year and recur-red once a year. Iridocyclitis was present in 42% of unilateral cases and 60% of bilateral cases. Compli-cations included thinning of the sclera 7 eyes in 5 cases, scleral staphyloma 5 eyes in 4 cases, corneal involvement 8 eyes in 6 caes, ocular hypertension 16 eyes in 14 cases, and chorioretinal lesions due to posterior scleritis 15 eyes in 12 cases.

While the prognosis of visual acuity was fair, these complications induced severe damges to the affected parts of the eye. Corticosteroid was usu-ally effective for the scleritis. Mild cases responded well to topical steroid. Severe cases required ad-ditional systemic administration.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(9) : 1075-1078,1987