黄斑浮腫に対するトリアムシノロン硝子体注射著効例の背景

Factors for the effect of intravitreal triamcinolone injection for macular edema

要約　目的：黄斑浮腫に対してトリアムシノロンの硝子体注入が奏効した症例の解析。対象と方法：過去20か月間にトリアムシノロンの硝子体注入を行った24例26眼のうち，視力が1.0となった6例7眼を著効例と定義して解析した。結果：著効例は，糖尿病網膜症12眼中3眼（25％），網膜静脈分枝閉塞症5眼中1眼（20％），網膜中心静脈閉塞症9眼中3眼（33％）であった。これら著効例は，そうでないものと比較して年齢が有意に低く，網膜静脈分枝閉塞症または網膜中心静脈閉塞症ではトリアムシノロンの硝子体注入までの期間が有意に短かった。結論：トリアムシノロンの硝子体注入は年齢が低いほど奏効し，網膜静脈分枝閉塞症と網膜中心静脈閉塞症では硝子体注入までの期間が短いほど効果がある。

Abstract.　Purpose：To identify factors for effectiveness of intravitreal triamcinolone injection for macular edema. Cases and Method：This retrospective study was made on 26 eyes of 24 patients who received intravitreal triamcinolone during the past 20 months. Cases were defined as success when best corrected visual acuity was 1.0 or over after treatment. Results：Visual acuity of 1.0 was attained in 3 out of 12 eyes（25％）of diabetic retinopathy,in 1 out of 5 eyes（20％）of branch retinal vein occlusion（BRVO）,and in 3 out of 9 eyes（33％）of central retinal vein occlusion（CRVO）. These success cases were characterized by significantly lower age than the rest. Interval between onset and treatment was significantly shorter in success cases of BRVO and CRVO. Conclusion：Intravitreal triamcinolone injection is more effective for macular edema in younger patients. It is more effective for BRVO and CRVO when performed earlier after onset.