糖尿病黄斑浮腫のタイプ別にみた硝子体手術とトリアムシノロンの併用効果

Outcome of vitreous surgery and intravitreal triamcinolone in various types of diabetic macular edema

　糖尿病黄斑浮腫13例20眼に硝子体手術を行い，手術終了直前にトリアムシノロン4mgを硝子体腔に注入した。術後6～9か月の観察で，2段階以上のlogMar視力の改善が13眼にあり，不変が7眼であった。これら7眼はすべて囊胞様黄斑浮腫（CME）と輪状網膜症が術前にあった。術前のCMEの内腔の高さが大きいほど術後視力が不良であった。以上，トリアムシノロン併用の硝子体手術は糖尿病黄斑浮腫に有効であるが，顕著なCMEまたは輪状網膜症がある場合には視力改善が困難であると結論される。

　Purpose：To evaluate the effect of vitreous surgery with adjunct use of intravitreal triamcinolone for diabetic macular edema. Cases and Methods：A total of 20 eyes in 13 cases received vitreous surgery for diabetic macular edema. Towards the end of surgery 4mg triamcinolone was injected into the vitreous. Cases were followed up for 6 to 9months after surgery. Findings：LogMar visual acuity improved by 2 lines or more in 13 eyes. It remained unchanged in 7 eyes. These 7 eyes had cystoid macular edema（CME）and circinate retinopathy prior to surgery. Post-op visual acuity was negatively correlated with the height of CME interspace. Conclusion：Adjunct use of intravitreal triamcinolone is effective for diabetic macular edema. It is of limited value in the presence of manifest CME or circinate retinopathy.