新しい評価法を用いた前部強膜炎の病態解析の検討

A novel grading system for assessing the activity of anterior scleritis

要約　目的：強膜炎の病像を充血と眼痛に基づいて独自のスコアで数値化し，その病態と経過を検討した報告。

対象と方法：過去55か月間に当科で前部強膜炎と診断した19例26眼を対象とした。男性6例，女性13例で，年齢は25〜80歳，平均56歳である。両眼性が7例，片眼性が12例であった。強膜炎の臨床スコアは，充血の範囲により1〜4，眼痛は鎮痛薬の要否により1〜3と評価した。1〜42か月，平均15か月の間，経過を観察した。

結果：臨床スコアは，充血と眼痛とも臨床症状とよく相関していた。前部強膜以外に炎症が波及しているときには臨床スコアに反映しない弱点があるが，眼合併症を併記することで改善できた。

結論：今回の新しい強膜炎の臨床スコアは簡便で，病状の経過と治療の評価に有用であった。

Abstract　Purpose: To report a novel grading system for assessing the activity of anterior scleritis.

Cases and Method: This study was made on 26 eyes of 19 cases who were diagnosed with anterior scleritis in the past 55 months. The series comprised 6 males and 13 females. The age ranged from 25 to 80 years, average 56 years. Scleritis was present in both eyes in 7 cases and in one eye in 12 cases. Hyperemia was graded into 1 to 4 points according to the area of involvement. Ocular pain was graded into 1 to 3 points regarding to the severity. Cases were followed up for 1 to 42 months, average 15 months.

Results: The clinical score reflected the clinical activity of scleritis regarding hyperemia and ocular pain. It showed poor correlation with the clinical feature when inflammation was not restricted to the anterior scleritis. This problem was solved by additional description of ocular complications other than scleritis.

Conclusion: The present grading system was simple to use and was useful in the follow-up of clinical course and evaluation of treatment.