網膜中心静脈閉塞症に対する硝子体手術の検討

Vitreous surgery for central retinal vein occlusion

目的：網膜中心静脈閉塞症に対する硝子体手術で，放射状視神経乳頭切開の併用例と非併用例の比較。対象：過去14か月間に硝子体手術を行い，3か月以上の経過を観察した網膜中心静脈閉塞症9例9眼を対象とした。発症後1～4か月の4眼には，硝子体手術に放射状視神経乳頭切開を併用した。発症後3～15か月の5眼にはこれを併用しなかった。結果：併用群での術後視力は改善3眼，不変0，悪化1眼であり，非併用群では改善1眼，不変3眼，悪化1眼であった。囊胞様黄斑浮腫（CME）は9眼中7眼で残存した。結論：放射状視神経乳頭切開は比較的安全な術式であり，網膜中心静脈閉塞症に対して奏効する可能性がある。

Purpose：To compare the outcome of vitreous surgery with or without radial optic neurotomy for central retinal vein occlusion. Cases：This retrospective study involved 9 eyes of 9 patients that underwent vitreous surgery for central retinal vein occlusion during the past 14 months. Radial optic neurotomy was performed in 4 eyes. These eyes were operated one to 4 months after onset. The other 5 eyes received vitreous surgery alone. These eyes were operated 3 to 15 months after onset. Cases were followed up for 3 months or longer. Results：Following radial optic neurotomy,visual acuity improved in 3 eyes and deteriorated in one. In the other 5 eyes,visual acuity improved in 1 eye,remained unchanged in 3,and deteriorated in one. Cystoid macular edema（CME）persisted in 7 eyes in the whole series. Conclusion：Radial optic neurotomy is a relatively safe procedure and may be effective for central retinal vein occlusion.