| V. ガイドライン | | | | II.危険因子 | | | | 4.薬物 | | | |
エビデンス | |
ステロイド薬 : コルチコステロイドが後嚢下混濁の危険因子であることは知られている1,2,3,4,5,6,7)(IV)。
鼻腔内投与では白内障発生リスクに関与しない8)(IV)。
ステロイドが白内障発生リスクとなる有意な変動はプレドニンの用量、治療期間、50才以上の年齢と糖尿病である9)(V)。
種々の抗精神病薬(ペンゾジアセピン、フェノチアジン、チオキサンチンなど)治療歴により白内障が有意に生じて進行した10,11)(IV)。
アスピリンと白内障の発生ならびに進行への相関に明らかな傾向は認められない12)(II)。
アロプリロール(血中尿酸値降下剤)は白内障を進行させる13,14)(IV)。 | | | | | | 1) | Phillips CI, Donnelly CA, Clayton RM, Cuthbert J: Skin disease and age-related cataract. Acta Derm Venereol 76 (4): 314-318, 1996 | | 2) | Miglior S, Marighi PE, Musicco M, Balestreri C, Nicolosi A, Orzalesi N: Risk factors for cortical, nuclear, posterior subcapsular and mixed cataract: a case-control study. Ophthalmic Epidemiol 1 (2): 93-105, 1994 | | 3) | Leske MC, Chylack LT Jr, Wu SY: The Lens Opacities Case-Control Study. Risk factors for cataract. Arch Ophthalmol 109 (2): 244-251, 1991 | | 4) | Tichelli A, Gratwohl A, Egger T, Roth J, Prunte A, Nissen C, Speck B: Cataract formation after bone marrow transplantation. Ann Intern Med 119 (12): 1175-1180, 1993 | | 5) | Hamon MD, Gale RF, Macdonald ID, Smith OP, Collis CH, Skeggs DB, Gandhi L, Prentice HG: Incidence of cataracts after single fraction total body irradiation: the role of steroids and graft versus host disease. Bone Marrow Transplant 12 (3): 233-236, 1993 | | 6) | Kaye LD, Kalenak JW, Price RL, Cunningham R: Ocular implications of long-term prednisone therapy in children. J Pediatr Ophthalmol Strabismus 30 (3): 142-144, 1993 | | 7) | The Italian-American Cataract Study Group: Risk factors for age-related cortical, nuclear, and posterior subcapsular cataracts. Am J Epidemiol 133 (6): 541-553, 1991 | | 8) | Derby L, Maier WC: Risk of cataract among users of intranasal corticosteroids. J Allergy Clin Immunol 105 (5): 912-916, 2000 | | 9) | Fryer JP, Granger DK, Leventhal JR, Gillingham K, Najarian JS, Matas AJ: Steroid-related complications in the cyclosporine era. Clin Transplant 8 (3 Pt 1): 224-229, 1994 | | 10) | McCarty CA, Wood CA, Fu CL, Livingston PM, Mackersey S, Stanislavsky Y, Taylor HR: Schizophrenia, psychotropic medication, and cataract. Ophthalmology 106 (4): 683-687, 1999 | | 11) | Isaac NE, Walker AM, Jick H, Gorman M: Exposure to phenothiazine drugs and risk of cataract. Arch Ophthalmol 109 (2): 256-260, 1991 | | 12) | Seddon JM, Christen WG, Manson JE, Buring JE, Sperduto RD, Hennekens CH: Low-dose aspirin and risks of cataract in a randomized trial of US physicians. Arch Ophthalmol 109 (2): 252-255, 1991 | | 13) | Garbe E, Suissa S, LeLorier J: Exposure to allopurinol and the risk of cataract extraction in elderly patients. Arch Ophthalmol 116 (12): 1652-1656, 1998 | | 14) | Leske MC, Chylack LT Jr, He Q, Wu SY, Schoenfeld E, Friend J, Wolfe J: Risk factors for nuclear opalescence in a longitudinal study. LSC Group. Longitudinal Study of Cataract. Am J Epidemiol 147 (1): 36-41, 1998 |
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