巨大血腫と滲出性網膜剝離を伴った加齢黄斑変性に対する硝子体手術

Vitreous surgery for age-related macular degeneration with serous retinal detachment and massive subretinal hematoma

目的：巨大血腫と滲出性網膜剝離を伴う加齢黄斑変性3眼に行った硝子体手術の報告。症例と経過：症例は65歳女性，78歳男性，87歳男性で，それぞれ発症から5日，3日，1日であった。網膜を180°から360°にわたり硝子体基底部後縁付近で切開し，網膜下血腫を除去した。2眼に大きな色素上皮裂孔があり血腫と網膜色素上皮の分離が困難で，網膜色素上皮欠損が残った。最終視力は色素上皮欠損がない1眼で0.1，これがある2眼ではそれぞれ0.03，0.01であった。結論：網膜下巨大血腫に対し今回行った硝子体手術は有効であった。

Purpose：To describe three eyes that received vitreous surgery for age-related macular degeneration with serous retinal detachment and massive subretinal hematoma. Cases and Findings：The present series comprised one female and two males,aged 65,78 and 87 years respectively. Sudden visual loss had persisted 5,3 and 1 day respectively. During surgery,retinotomy was performed for 180 to 360 degrees along the posterior vitreous border,followed by aspiration of subretinal hematoma. Two eyes had giant break of retinal pigment epithelium（RPE）. Separation of hematoma from RPE was difficult in these eyesand resulted in RPE defect. Final visual acuity was 0.1 in an eye without RPE defect and 0.03 and 0.01 with RPE defect. Conclusion：Vitreous surgery was effective for giant subretinal hematoma in the present series.