糖尿病黄斑浮腫の光干渉断層計による分類および硝子体手術の術後経過

Outcome of vitreous surgery and patterns of diabetic macular edema evaluated by optical coherence tomography

要約　硝子体手術による後部硝子体剝離形成を糖尿病黄斑浮腫16眼に行い，その術後経過を術前の浮腫形態と比較した。浮腫の形態は光干渉断層計（OCT）で評価し，Kishiらの分類を用いた。術前の黄斑浮腫は，囊胞様黄斑浮腫にスポンジ様腫脹を伴うもの9眼，スポンジ様腫脹3眼，漿液性網膜剝離にスポンジ様腫脹を伴うもの4眼であった。それぞれの群の術前視力は0.15，0.25，0.35，術後視力は0.15，0.46，1.02であった。漿液性網膜剝離にスポンジ様腫脹を伴う群で視力の改善が顕著であり，この形の糖尿病黄斑浮腫に対して後部硝子体剝離形成術が特に奏効すると推定される。

Abstract.　We performed vitreous surgery with posterior vitreous detachment in 16 eyes of diabetic macular edema. The outcome was compared with the preoperative findings of macular edema as seen by optical coherence tomography（OCT）. We used the classification by Kishi et al（1999）. The preoperative macular edema was classified as cystoid macular edema（CME）with sponge-like swelling 9 eyes,sponge-like swelling 3 eyes,and serous retinal detachment with sponge-like swelling 4 eyes. The preoperative visual acuity averaged 0.15,0.25 and 0.35 respectively. The preoperative visual acuity averaged 0.15,0.46 and 1.02 respectively. The findings show that improvement in visual acuity was more pronounced in eyes of serous retinal detachment with sponge-like swelling. Vitreous surgery with posterior vitreous detachment seems to be indicated for this type of diabetic macular edema.