蕪城 俊克

Diabetic retinopathy (DR) can cause visual impairment and blindness, and the increasing global prevalence of diabetes underscores the need for effective therapies to prevent and treat DR. Therefore, this study aimed to evaluate the protective effect of pemafibrate treatment against DR, using a Spontaneously Diabetic Torii (SDT) fatty rat model of obese type 2 diabetes. SDT fatty rats were fed either a diet supplemented with pemafibrate (0.3 mg/kg/day) for 16 weeks, starting at 8 weeks of age (Pf SDT fatty: study group), or normal chow (SDT fatty: controls). Normal chow was provided to Sprague-Dawley (SD) rats (SD: normal controls). Electroretinography (ERG) was performed at 8 and 24 weeks of age to evaluate the retinal neural function. After sacrifice, retinal thickness, number of retinal folds, and choroidal thickness were evaluated, and immunostaining was performed for aquaporin-4 (AQP4). No significant differences were noted in food consumption, body weight, or blood glucose level after pemafibrate administration. Triglyceride levels were reduced, and high-density lipoprotein cholesterol levels were increased. Extension of oscillatory potential (OP)1 and OP3 waves on ERG was suppressed in the Pf SDT fatty group. Retinal thickness at 1,500 microns from the optic disc improved in the Pf SDT fatty group. No significant improvements were noted in choroidal thickness or number of retinal folds. Quantitative analyses showed that AQP4-positive regions in the retinas were significantly larger in the Pf SDT fatty group than in the SDT fatty group. The findings suggest that pemafibrate treatment can exert protective effects against DR.

＜文献概要＞目的:東京大学医学部附属病院(以下,当院)における2019～2021年のぶどう膜炎初診患者の統計調査。対象と方法:上記期間に当院を初診したぶどう膜炎患者520例を対象とした。診療録をもとに,年齢,性別,罹患眼,解剖学的病変部位,診断名などについて検討を行った。過去の当院の統計結果,全国疫学調査の結果と比較した。結果:初診時平均年齢54.1±20.0歳,男性223例(42.9%),女性297例(57.1%)であった。両眼性307例(59.0%),片眼性213例(41.0%)であった。前部ぶどう膜炎206例(39.6%),中間部ぶどう膜炎16例(3.1%),後部ぶどう膜炎74例(14.2%),汎ぶどう膜炎224例(43.1%)であった。診断がついた症例は353例(67.9%)であり,サルコイドーシス51例(9.8%),ヘルペス性虹彩炎37例(7.1%),急性前部ぶどう膜炎36例(6.9%),眼内悪性リンパ腫34例(6.5%),Vogt-小柳-原田病24例(4.6%),ベーチェット病23例(4.4%),の順であった。抗腫瘍薬関連の薬剤性ぶどう膜炎を8例(1.5%)に認めた。結論:2016～2018年の当院の統計結果と比較し,原因疾患の傾向はほぼ同じであった。全国疫学調査と比較し,当院では眼内悪性リンパ腫が多い結果であった。抗腫瘍薬関連の薬剤性ぶどう膜炎症例が増加しており,今後も増加が予想される。