切迫型網膜中心静脈閉塞症様所見を伴う網膜上膜の手術予後

Outcome of surgery for epiretinal membrane with fundus lesions simulating impending central retinal vein occlusion

　過去3年間に硝子体手術を行った特発性網膜上膜216眼のうち，網膜静脈にびまん性の蛇行・拡張，すなわち切迫型網膜中心静脈閉塞症様の変化がある20眼の診療録を検索した。手術により視力が2段階以上改善したのは5眼（25％）のみであった。網膜上膜への硝子体手術では概して良好な術後視力が得られるが，網膜血管の変形または蛇行が合併していると予後が不良になりがちである。切迫型網膜中心静脈閉塞症様の変化を伴う網膜上膜では，蛍光眼底造影で黄斑部に色素漏出がなくても，手術適応の決定を慎重にする必要がある。

　We performed vitreous surgery for epiretinal membrane in 216 eyes during the past 3-year period. We selected and reviewed 20 eyes in this series. These eyes were characterized by the presence of diffuse dilatation and tortuosity of retinal veins simulating impending central retinal vein occlusion. Postoperative visual acuity improved by 2 lines or more in only 5 eyes（25％）. This finding shows that surgical outcome may be poor when epiretinal membrane is associated by abnormal retinal veins. We advocate due precaution before deciding surgery for epiretinal membrane in such cases even in the absence of manifest fluorescein angiographic abnormalities.