糖尿病黄斑症における硬性白斑の局在と黄斑形態と視力の関係

Relations among location of hard exudate,pattern of macular edema and visual acuity in diabetic retinopathy

要約　目的：糖尿病黄斑症での硬性白斑の局在，黄斑浮腫の形態，矯正視力の関係の検索。対象と方法：硬性白斑がある糖尿病黄斑症300眼を対象とした。硬性白斑は光干渉断層計（OCT）で検索し，網膜内と網膜下に分けた。黄斑形態はKishiの分類を改変した方法で分類した。結果：硬性白斑はOCTでは237眼（79％）に検出され，151眼（64％）では網膜内のみ，86眼（36％）では網膜内と網膜下にあった。網膜下にある硬性白斑では，網膜内にあるものよりも矯正視力が不良であり，囊胞様黄斑浮腫または漿液性網膜剝離が併発する頻度が高かった。結論：硬性白斑が網膜下にある眼では，黄斑の形態にかかわらず矯正視力が不良である。

Abstract.　Purpose：To report relations among location of hard exudate,pattern of macular edema and visual acuity in diabetic retinopathy. Material and Method：This study was made on 300 eyes of diabetic retinopathy with hard exudates. Hard exudates were classified into intraretinal and subretinal ones by an optical coherence tomography（OCT）. Morphology of macular edema was classified by modified method by Kishi. Results：Hard exudate was detected in 237 eyes（79％）by OCT. It was located intraretinally in 151 eyes（64％）and subretinally in 86 eyes（36％）. Eyes with subretinal hard exudates had poorer best-corrected visual acuity than those with intraretinal ones. They had a higher incidence of cystoid macular edema or serous retinal detachment. Conclusion：Diabetic eyes with subretinally located hard exudate have poorer visual acuity regardless of macular pattern.