臨床眼科60巻2号

2006年02月発行

特集 どこまで進んだ 分子病態の解明と標的治療

緑内障性視神経症

著者： 中村誠¹

所属機関： ¹神戸大学大学院医学系研究科器官治療医学講座眼科学分野

ページ範囲：P.144 - P.151

はじめに

　多治見スタディで明らかになったように，40歳以上の日本人の5％は緑内障であり，また3.9％は広義の原発開放隅角緑内障（primary open-angle glaucoma：POAG）である^1）。POAGは，世界的にみれば6,000万人以上が罹患する失明原因の第2位を占める疾患であり^2），網膜神経節細胞（retinal ganglion cell：RGC）とその軸索の進行性不可逆性の消失を特徴とした，多因子視神経疾患である^3）。POAGは他の視神経疾患とは異なり，特徴的な視神経乳頭の陥凹を形成することから，以前より，篩状板での機械的圧迫，循環障害がその原因であると論争されてきた。近年の細胞生物学的研究の進歩により，このやや抽象的な機械障害説ないし循環障害説を，もう少し具体的に論じることが可能となってきた。本稿では，グリア細胞とRGCの関連を中心に，現在推定されている緑内障性視神経症の成因と標的治療を概説したい。

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