臨床眼科72巻2号

2018年02月発行

特集 眼窩疾患の最近の動向

甲状腺眼症の病態と診療のコツ

著者： 石川恵里¹ 高橋靖弘¹ 柿﨑裕彦¹

所属機関： ¹愛知医科大学病院眼形成・眼窩・涙道外科

ページ範囲：P.182 - P.194

はじめに

　甲状腺眼症は，甲状腺自己抗体に関連した自己免疫性炎症性疾患で，眼窩部が標的となる病態である。甲状腺機能異常が発症の発端となるが，発症後は通常，甲状腺機能とは無関係に変動する^1）。甲状腺眼症はその発症初期において，必ずしも特徴的な顔貌の変化や眼球運動障害を認めないため，「甲状腺眼症」の診断に至らず，単にドライアイや眼精疲労などとして経過観察され，治療が後手に回ることも少なくない^1）。

　甲状腺眼症の適切な治療介入のためには，その病態と臨床像について理解を深めておく必要がある。本稿では，甲状腺眼症の病態，甲状腺疾患との関係，診断・活動性の評価，および重症度に応じた治療について，最近の知見を加えて解説する。

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