Sheathotomy術後ごく早期から視力が改善した網膜静脈分枝閉塞症の1例

Early recovery of visual acuity in a case after sheathotomy for branch retinal vein occlusion

目的：動静脈交叉部鞘切開術が奏効した網膜静脈分枝閉塞症症例の報告。症例：72歳女性が6か月前からの左眼視力低下で受診した。左眼に下耳側の網膜静脈分枝閉塞症があり，矯正視力は0.09であった。1か月後に動静脈交叉部鞘切開術を行った。その8時間後の眼底写真で交叉部近位の静脈に血流増加があり，蛍光眼底造影で静脈充盈遅延が改善していた。視力は，1週後0.6，6週後0.8，10週後1.0，6か月後1.2であった。結論：網膜静脈分枝閉塞症に対し，動静脈交叉部鞘切開術が著効を示すことがある。

Purpose：To report the outcome of arteriovenous sheathotomy in a case of branch retinal vein occlusion（BRVO）. Case：A 72-year-old female presented with impaired visual acuity in her left eye of 6 months' duration. Her corrected visual acuity was 1.0 right and 0.09 left. The left eye showed BRVO inferotemporal to the disc. Arteriovenous sheathotomy was performed one month later. Fundus photograph taken 8 hours after surgery showed improved circulation proximal to the site of venous occlusion. Fluorescein angiography showed improved venous filling in the affected area. Visual acuity improved to 0.6 after one week,0.8 after 6 weeks,1.0 after 10 weeks and 1.2 after 6 months. Conclusion：Arteriovenous sheathotomy may be very effective for BRVO.