臨床眼科73巻1号

2019年01月発行

特集 今が旬！ アレルギー性結膜炎

重症アレルギー性結膜疾患の治療選択

著者： 藤島浩¹

所属機関： ¹鶴見大学歯学部眼科学講座

ページ範囲：P.48 - P.56

はじめに

　重症アレルギー性結膜疾患は，一般的な花粉症などによるアレルギー性結膜炎と異なり，角膜に炎症や潰瘍を伴い，激しい疼痛や視力低下を伴う疾患である。本稿では，重症アレルギー性結膜疾患の概念と筆者が考える病因と臨床像を紹介したうえで，本疾患への治療法として免疫抑制薬点眼治療と手術治療を紹介する。

　免疫抑制薬点眼治療は重症疾患への第一選択と考えている。特にタクロリムス（FK-506；0.1％タリムス^®点眼薬，千寿製薬）は非常に効果的で，ほぼ90％の重症疾患が本剤で軽快する。ただ，副作用として異物感や熱感があり，また高価な点眼であるので，患者とよく相談のうえ，処方する必要がある。一方，手術療法は非常に即効性があり，点眼などの保存療法で軽快しない症例にはぜひ勧めたい治療法の1つである。手術療法の後で免疫抑制薬点眼液を使用すれば，プロアクティブ療法として再発率も低くなり効果的である。

参考文献

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