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<meta name="description" content="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．C">

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		<h1 class="catchCopy">近視を「治療」するための全ては，この一冊に！</h1>
		

		<h1 class="copy">クリニックではじめる</h1>
		<h1 class="title">学童の近視抑制治療<span class="version"></span></h1>
		<h2 class="subTitle">最新エビデンスとエキスパートから学ぶ実用メソッド</h2>

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					編集：平岡孝浩（筑波大学准教授）
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					<span class="transparent">編集</span>　二宮さゆり（伊丹中央眼科院長）
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				<ul class="property"><li class="disc">B5判・232頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-5607-1</li><li class="disc">2021年5月21日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">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．</section><section class="preface">序文<br><br>　想像してほしい．<br><br>─あなたは強度近視で数年前に緑内障を発症した．視野狭窄の恐怖に怯えながら毎晩の点眼を欠かさずに継続している．正直辛い．そんなあなたの子供は小学校4 年生ですでに－4Dの近視があり，ここ1年で1D進行した．<br><br>　さて，あなたは実子に眼鏡だけ処方しますか？ それとも可能性のある治療を試してみますか？<br>　巷には類似のケースが溢れている．診療の場において我々が最も多く遭遇する疾患は近視であろう．しかし，そのごくありふれた近視が近年大変なことになっている．2050年には世界人口の約50% にあたる50億人が近視になると試算され，そのうち約10億人が強度近視に至る可能性が示唆されている．将来的に近視関連眼疾患を発症し，失明に至るものも当然増えるだろう．医療経済への負担も年々増していく．<br>　このような異常事態に，眼科医や視能訓練士をはじめとするEye Care Practitioner（目の健康に携わるすべての職種）は何をすべきか？ 近視抑制に積極的に取り組むべきではないか？<br>　これまで20年以上にわたり近視および近視抑制の臨床研究に携わってきたが，エビデンスの着実な積み上げを実感している．低濃度アトロピン点眼の有効性と安全性が証明され，リバウンドも含めた長期経過が報告された．オルソケラトロジーの眼軸長伸長抑制効果も多くの研究で証明され，5〜10年の長期データも報告されている．RCT（前向きランダム化比較試験）も各手法で広く行われるようになり，多焦点ソフトCLにおいても5年を超えるデータが登場してきた．そして，海外では複数のCLや薬剤が承認され，学童はその恩恵を受けることが可能となっている．<br>　近視回復トレーニングなど信憑性の低い方法とは異なり，近年の近視抑制治療はエビデンスを伴っており，患者や保護者に推奨できる根拠がある．両親が強度近視，あるいは近視関連合併症を発症していることで，近視進行を切実に悩む患者に提示できる手段がある．<br>　本書は，Eye Care Practitionerを対象として，近視抑制治療の現況と治療を実践するために必要な情報を提供する目的で，各領域の専門家にできるだけわかりやすく解説してもらった．もちろん，導入するにはハードルが高いと感じる治療もあるだろう．しかし，世界ではすでに標準的に行われていることが多数であり，近い将来この大波は間違いなくやってくる．オーストラリアなど近視頻度が日本よりも圧倒的に低い国ですら，近視抑制治療に真剣に取り組んでいる．<br>　デジタル社会が加速し，患者もさまざまな情報を容易に入手できるようになった．各手法を実践するか否かは別として，我々は患者に正しい情報を伝える義務がある．その情報源として本書をご活用いただければ幸いである．そして，近視抑制治療の最先端に触れていただき，皆様の近視に対する取り組み方が少しでも前向きになるのであれば望外の喜びである．<br><br>2021年4月吉日　平岡孝浩</section><section class="indexes">Ⅰ章　はじめに─近視診療の現況─<br>　A．日本における近視の現況<br>　　1．「近視パンデミック」といえる緊急事態<br>　B．教育現場における近視の現況<br>　　1．学校でのICT活用の推進とこれからの学習環境<br>　C．近視学童の実際<br>　　1．近視学童が来院したときの心構え<br>　　2．近視抑制治療のフローチャート<br><br>Ⅱ章　近視診療で評価すべき検査と診断<br>　A．近視診療で役立つ検査項目─「意義」と「頻度」<br>　　1．調節麻痺下検査<br>　　2．眼軸長，ケラト値と角膜トポグラフィ，脈絡膜厚<br>　　3．両眼開放レフ・調節ラグ<br>　B．近視診療で便利な機器のレビューと活用法<br>　　1．眼軸長測定機器（OA-2000）<br>　　2．屈折機能検査「SPOT™ Vision Screener」<br>　　［コラム］Myopia Master<sup>®</sup>（マイオピア・マスター）<br><br>Ⅲ章　視力矯正─眼鏡処方，CL 処方の実際─<br>　A．眼鏡処方<br>　　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！<br>　B．コンタクトレンズ処方<br>　　1．子供へのコンタクトレンズ処方について<br><br>Ⅳ章　近視抑制─各種治療法の実際─<br>　A．近視抑制の概要<br>　　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？<br>　B．オルソケラトロジー<br>　　1．オルソケラトロジーのオーバービュー<br>　　2．オルソケラトロジーの適応患者<br>　　3．オルソケラトロジーの種類<br>　　4．オルソKの処方・使用上の注意<br>　　　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<br>　　　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<br>　　　c．代表的な合併症とトラブル発生時の対処法<br>　　　d．学童や保護者への説明<br>　　5．オルソKのフォローアップとアフターケア<br>　　　a．視力安定までの期間と対処法<br>　　　b．取り扱い上の注意点─レンズのケアと交換目安<br>　　　c．確実に定期来院させる「治療プラン」の工夫<br>　　6．オルソKの導入方法／価格設定<br>　　　a．導入までの流れと初期費用<br>　　　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<br>　　　c．院内での価格設定2─ブレスオーコレクト<br>　　　d．院内での価格設定3─マイエメラルド<br>　　7．オルソKの法律・公的事項<br>　　　a．運転免許など公的事項での扱い<br>　　　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<br>　C．多焦点ソフトコンタクトレンズ<br>　　1．多焦点ソフトコンタクトレンズのオーバービュー<br>　　2．多焦点ソフトコンタクトレンズの適応患者<br>　　3．多焦点ソフトコンタクトレンズの種類<br>　　　a．累進屈折型<br>　　　b．EDOF-SCL<br>　　　c．非球面ソフトコンタクトレンズ<br>　　　d．同心円型<br>　　4．多焦点ソフトコンタクトレンズの処方・使用上の注意<br>　　　a．処方の基本─ハロー・グレア問題と対処法<br>　　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<br>　　　a．定期受診とケアの注意点<br>　　6．多焦点ソフトコンタクトレンズの導入方法・価格設定<br>　　7．多焦点ソフトコンタクトレンズの法律・公的事項<br>　　　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<br>　D．特殊眼鏡<br>　　1．特殊眼鏡のオーバービュー<br>　　2．特殊眼鏡の有効性・処方・使用上の注意点<br>　E．低濃度アトロピン点眼<br>　　1．低濃度アトロピン点眼のオーバービュー<br>　　2．低濃度アトロピン点眼の処方・使用上の注意<br>　　　a．合併症と対処法<br>　　　b．併用療法の効果はどの程度期待できる？<br>　　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<br>　　4．導入方法/価格設定<br>　　　a．マイオピン™<br>　F．近視抑制治療アフターケアの最新研究<br>　　1．治療はいつまで続ける必要があるのか？<br>　　2．リバウンドの最新情報とリバウンドを防ぐコツ<br>　　3．長期データ<br>　G．屋外活動<br>　　1．屋外活動による近視抑制のオーバービュー<br>　　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？<br>　　3．屋外活動の何が近視抑制に効果があるのか？<br>　H．その他の治療<br>　　1．サプリメント<br>　　2．バイオレットライト透過眼鏡<br>　　3．遺伝の影響と遺伝子治療の可能性<br>　　［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<br>　　［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<br>　　［コラム］執筆者アンケート「My best近視抑制治療」<br><br>Ⅴ章　学童の近視Q&amp;A─近視抑制7つの疑問─<br>　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？<br>　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？<br>　Q3．「明るい部屋で読書をすると眼に良い」は本当？<br>　Q4．「30分ごとに休憩をはさむと眼に良い」は本当？<br>　Q5．「スマートフォン，テレビ，ゲームは眼に悪い」は本当？<br>　Q6．「斜視があると近視は進みやすい」は本当？<br>　Q7．「寝不足や不規則な食事が眼に悪い」は本当？<br><br>文献<br>索引</section></article>
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