クリニックではじめる　学童の近視抑制治療

出版社： 文光堂
著者：
発行日： 2021-05-19
分野： 臨床医学：外科  >  眼科学
ISBN： 9784830656071
電子書籍版： 2021-05-19 （第1版第1刷）
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商品紹介

近視学童が来院したとき，あなたは眼鏡だけ処方しますか……それとも，近視を「治療」しますか？本書は眼科医・ORTを対象とした，近視抑制治療を実践するための指南書である．近視研究エキスパートの執筆陣が，確かな最新エビデンスを根拠に信頼性の高い処方ノウハウを実践的にレクチャー．治療成功のカギを握る，患者や保護者とのコミュニケーション・価格設定・法律など，クリニック目線での懸念事項にも大きく頁を割いた．COVID-19による新しい生活様式は近視傾向を加速させるといわれ，メディアでも「近視抑制」が扱われる機会は増えつつある．患者の「近視抑制」への関心が高まる中で，今，「最先端の近視抑制治療」は避けて通れない知識といえる．子どもが来院するすべての眼科クリニック必携の一冊．

目次

  • I章　はじめに─近視診療の現況─
    　A．日本における近視の現況
    　　1．「近視パンデミック」といえる緊急事態
    　B．教育現場における近視の現況
    　　1．学校でのICT活用の推進とこれからの学習環境
    　C．近視学童の実際
    　　1．近視学童が来院したときの心構え
    　　2．近視抑制治療のフローチャート

    II章　近視診療で評価すべき検査と診断
    　A．近視診療で役立つ検査項目─「意義」と「頻度」
    　　1．調節麻痺下検査
    　　2．眼軸長，ケラト値と角膜トポグラフィ，脈絡膜厚
    　　3．両眼開放レフ・調節ラグ
    　B．近視診療で便利な機器のレビューと活用法
    　　1．眼軸長測定機器（OA-2000）
    　　2．屈折機能検査「SPOT™ Vision Screener」
    　　［コラム］Myopia Master®（マイオピア・マスター）

    III章　視力矯正─眼鏡処方，CL 処方の実際─
    　A．眼鏡処方
    　　1．開業医のための“現実的”矯正方法
    　　　　─低矯正 or 完全矯正に囚われるのはもうやめよう！
    　B．コンタクトレンズ処方
    　　1．子供へのコンタクトレンズ処方について

    IV章　近視抑制─各種治療法の実際─
    　A．近視抑制の概要
    　　1．近視進行を抑制する意義─30，40，50%抑制すると合併症はどの程度減るのか？
    　B．オルソケラトロジー
    　　1．オルソケラトロジーのオーバービュー
    　　2．オルソケラトロジーの適応患者
    　　3．オルソケラトロジーの種類
    　　4．オルソKの処方・使用上の注意
    　　　a．処方の基本─ファーストレンズの選び方，フィッティングのチェック
    　　　b．ハイパワー／角膜乱視用オルソケラトロジーの処方
    　　　　　─オルソケラトロジー先進国，中国での症例
    　　　c．代表的な合併症とトラブル発生時の対処法
    　　　d．学童や保護者への説明
    　　5．オルソKのフォローアップとアフターケア
    　　　a．視力安定までの期間と対処法
    　　　b．取り扱い上の注意点─レンズのケアと交換目安
    　　　c．確実に定期来院させる「治療プラン」の工夫
    　　6．オルソKの導入方法／価格設定
    　　　a．導入までの流れと初期費用
    　　　b．院内での価格設定1─メニコンオルソK，ブレスオーコレクト
    　　　c．院内での価格設定2─ブレスオーコレクト
    　　　d．院内での価格設定3─マイエメラルド
    　　7．オルソKの法律・公的事項
    　　　a．運転免許など公的事項での扱い
    　　　b．宣伝はどの程度まで許されるか？─ホームページ，広告，院内ポスター
    　C．多焦点ソフトコンタクトレンズ
    　　1．多焦点ソフトコンタクトレンズのオーバービュー
    　　2．多焦点ソフトコンタクトレンズの適応患者
    　　3．多焦点ソフトコンタクトレンズの種類
    　　　a．累進屈折型
    　　　b．EDOF-SCL
    　　　c．非球面ソフトコンタクトレンズ
    　　　d．同心円型
    　　4．多焦点ソフトコンタクトレンズの処方・使用上の注意
    　　　a．処方の基本─ハロー・グレア問題と対処法
    　　5．多焦点ソフトコンタクトレンズのフォローアップとアフターケア
    　　　a．定期受診とケアの注意点
    　　6．多焦点ソフトコンタクトレンズの導入方法・価格設定
    　　7．多焦点ソフトコンタクトレンズの法律・公的事項
    　　　a．宣伝はどの程度まで許されるか？─ホームページ，広告，院内ポスター
    　D．特殊眼鏡
    　　1．特殊眼鏡のオーバービュー
    　　2．特殊眼鏡の有効性・処方・使用上の注意点
    　E．低濃度アトロピン点眼
    　　1．低濃度アトロピン点眼のオーバービュー
    　　2．低濃度アトロピン点眼の処方・使用上の注意
    　　　a．合併症と対処法
    　　　b．併用療法の効果はどの程度期待できる？
    　　3．低濃度アトロピン点眼のフォローアップとアフターケア
    　　4．導入方法/価格設定
    　　　a．マイオピン™
    　F．近視抑制治療アフターケアの最新研究
    　　1．治療はいつまで続ける必要があるのか？
    　　2．リバウンドの最新情報とリバウンドを防ぐコツ
    　　3．長期データ
    　G．屋外活動
    　　1．屋外活動による近視抑制のオーバービュー
    　　2．学校の休み時間の過ごし方─校庭で遊ぶと近視抑制になるのか？
    　　3．屋外活動の何が近視抑制に効果があるのか？
    　H．その他の治療
    　　1．サプリメント
    　　2．バイオレットライト透過眼鏡
    　　3．遺伝の影響と遺伝子治療の可能性
    　　［コラム］日本は世界から遅れている!?諸外国から，子供の目を守る取り組み
    　　［コラム］シンガポールの診療現場から─近視進行抑制“先進国”での実情
    　　［コラム］執筆者アンケート「My best近視抑制治療」

    V章　学童の近視Q&A─近視抑制7つの疑問─
    　Q1．近視抑制治療は何歳から始めて，何歳に終われば良いですか？
    　Q2.「30cm以上の視距離をとって，正しい姿勢で読書をすると眼に良い」は本当？
    　Q3.「明るい部屋で読書をすると眼に良い」は本当？
    　Q4.「30分ごとに休憩をはさむと眼に良い」は本当？
    　Q5.「スマートフォン，テレビ，ゲームは眼に悪い」は本当？
    　Q6.「斜視があると近視は進みやすい」は本当？
    　Q7.「寝不足や不規則な食事が眼に悪い」は本当？

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I章 はじめに - 近視診療の現況 -

P.2 掲載の参考文献
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2) Yotsukura E, et al : Current prevalence of myopia and association of myopia with environmental factors among schoolchildren in Japan. JAMA Ophthalmol 137 : 1233-1239, 2019
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15) Chua SY, et al : Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children. Ophthalmic Physiol Opt 36 : 388-394, 2016
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II章 近視診療で評価すべき検査と診断

P.18 掲載の参考文献
1) Cho P, et al : Protective role of orthokeratology in reducing risk of rapid axial elongation : a reanalysis of data from the ROMIO and TO-SEE Studies. Invest Ophthalmol Vis Sci 58 : 1411-1416, 2017
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2) Chung K, et al : Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res 42 : 2555-2559, 2002
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3) Adler D, et al : The possible effect of undercorrection on myopic progression in children. Clin Exp Optom 89 : 315-321, 2006
PubMed
4) Vasudevan B, et al : Under-correction of human myopia--is it myopigenic? : a retrospective analysis of clinical refraction data. J Optom 7 : 147-152, 2014
 
5) Li SY, et al : Effect of undercorrection on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 253 : 1363-1368, 2015
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6) Yazdani N, et al : Under-correction or full correction of myopia? A meta-analysis. J Optom 14 : 11-19, 2021
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P.22 掲載の参考文献
1) Huang CY, et al : Relationship of lifestyle and body stature growth with the development of myopia and axial length elongation in Taiwanese elementary school children. Indian J Ophthalmol 62 : 865-869, 2014
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2) Kearneya S, et al : Change in body height, axial length and refractive status over a four-year period in caucasian children and young adults. J Optom 13 : 128-136, 2020
 
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2) Lin Z, et al : Peripheral defocus with single-vision spectacle lenses in myopic children. Optom Vis Sci 87 : 4-9, 2010
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III章 視力矯正 - 眼鏡処方, CL処方の実際 -

P.36 掲載の参考文献
1) Chung K, et al : Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res 42 : 2555-2559, 2002
PubMed
2) Adler D, et al : The possible effect of undercorrection on myopic progression in children. Clin Exp Optom 89 : 315-321, 2006
PubMed
3) Vasudevan B, et al : Under-correction of human myopia--is it myopigenic? : a retrospective analysis of clinical refraction data. J Optom 7 : 147-152, 2014
 
4) Chen YH : Clinical observation of the development of juvenile myopia wearing glasses with full correction and undercorrection. Int J Ophthalmol 14 : 1553-1554, 2014
 
5) Li SY, et al : Effect of undercorrection on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 253 : 1363-1368, 2015
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6) Sun YY, et al : Effect of uncorrection versus full correction on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 255 : 189-195, 2017
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7) Yazdani N, et al : Under-correction or full correction of myopia? A meta-analysis. J Optom 14 : 11-19, 2020
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IV章 近視抑制 - 各種治療法の実際 -

P.46 掲載の参考文献
1) Haarman AEG, et al : The complications of myopia : a review and meta-analysis. IOVS 61 : 49, 2020
 
2) Holden BA, et al : Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 123 : 1036-1042, 2016
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3) Flitcroft DI, et al : IMI-defining and classifying myopia : a proposed set of standards for clinical and epidemiologic studies. Invest Ophthalmol Vis Sci 60 : M20-M30, 2019
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P.48 掲載の参考文献
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2) Cho P, et al : The longitudinal orthokeratology research in children (LORIC) in Hong Kong : a pilot study on refractive changes and myopic control. Curr Eye Res 30 : 71-80, 2005
 
3) Walline JJ, et al : Corneal reshaping and myopia progression. Br J Ophthalmol 93 : 1181-1185, 2009
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4) Kakita T, et al : Influence of overnight orthokeratology on axial length elongation in childhood myopia. Invest Ophthalmol Vis Sci 52 : 2170-2074, 2011
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8) Li SM, et al : Efficacy, safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis. Curr Eye Res 41 : 600-608, 2016
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V章 学童の近視 Q & A - 近視抑制7つの疑問 -

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