網膜静脈分枝閉塞に伴う黄斑浮腫に対するトリアムシノロン後部テノン囊下投与と光凝固

Treatment of macular edema secondary to branch retinal vein occlusion by retrobulbar injection of triamcinolone acetonide and photocoagulation

黄斑浮腫を伴う網膜静脈分枝閉塞15例15眼に網膜光凝固とトリアムシノロンの後部テノン囊下投与を行った。男性9例，女性6例で，年齢は45～88歳，平均66歳であった。発症から治療までの期間は3週間～29か月，平均6.0か月で，3～12か月，平均8.0か月の経過観察を行った。視力は11眼（73％）で2段階以上改善し，2眼（13％）で不変，2眼（13％）で2段階以上悪化した。平均視力は術前0.33，術後0.55であり，有意差があった（p=0.015）。中心窩厚は術前462±123μm，術後261±120μmで有意に減少した（p＜0.0001）。6眼（40％）で黄斑浮腫が再発した。高眼圧が1眼（7％）に起こったが，これ以外の重篤な合併症はなかった。本治療は初回治療として有効であるが，再発例には追加治療が必要であると結論される。

We treated 15 eyes of macular edema secondary to branch retinal vein occlusion by retrobulbar injection of triamcinolone acetonid followed by laser photocoagulation 2 weeks later. The series comprised 9 males and 6 females. Their ages ranged from 45 to 88 years,average 66 years. The interval between onset and treatment ranged from 3 weeks to 29 months,average 6.0 months. Cases were followed up for 3 to 12 months,average 8.0 months. Visual acuity improved by 2 lines or more in 11 eyes（73％）,remained unchanged in 2 eyes（13％）,and deteriorated by 2 lines or more in 2 eyes（13％）. The visual acuity averaged 0.33 before treatment and 0.55 after treatment. The difference was significant（p＝0.015）The foveal thickness averaged 462±123μm before treatment and 261±120μm after treatment. The difference was significant（p＜0.0001）. Macular edema recurred in 6 eyes（40％）. Ocular hypertension developed in 1 eye（7％）. There were no other severe complications. The findings show the efficacy of the present therapeutic modality. Additinal treatment may be necessary for recurrences.