多量の網膜下出血をきたした加齢黄斑変性に対する硝子体手術の1例

Vitreous surgery for massive subretinal hemorrhage in a case of age-related macular degeneration

目的：加齢黄斑変性で多量の網膜下出血が生じた症例に硝子体出血を行った症例の報告。症例と経過：86歳男性の右眼に視力低下が突発した。右眼は偽水晶体眼と加齢黄斑変性があり，後極部に網膜下出血があった。矯正視力は0.01であった。左眼は外傷で失われ，義眼を装用していた。血腫を移動させるために100％C₃F₈ガスを硝子体腔に注入した。その5か月後に硝子体出血が起こり，硝子体手術を行った。さらに9日後に多量の網膜下出血が生じた。網膜周辺部を切開し，網膜を反転し，凝血塊を除去した。0.05の最終視力を得た。結論：加齢黄斑変性に併発した多量の網膜出血に対し，網膜周辺部を切開し，網膜を反転したうえで凝血塊を除去する方法が有効であった。

Purpose：To describe a case who received vitreous surgery for massive subretinal hemorrhage secondary to age-related macular degeneration. Case：A 86-year-old male developed acute blurring of vision in his right eye. His right eye had pseudophakia,age-related macular degeneration,and massive subretinal hemorrhage in the posterior fundus. Corrected visual acuity was 0.01. His left eye had been lost due to trauma. The right eye was treated by intravitreal injection of 100％ perfluoropropane to displace subretinal hemorrhagic mass. The right eye developed vitreous hemorrhage 5 months later and was treated by vitrectomy. Massive subretinal hemorrhage occurred another 9 days later. After peripheral retinotomy,the coagulated blood was removed under direct observation. The patient has been doing well ever since with visual acuity of 0.05. Conclusion：Peripheral retinotomy with removal of subretinal blood under direct observation was effective for massive subretinal hemorrhage.