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要約 血管新生緑内障を伴う糖尿病網膜症29例40眼を過去6年間の診療録の記録に基づいて検索した。男性22例32眼,女性7例8眼で,年齢は47~74歳,平均58歳であった。当初から光覚弁がない症例と手術が行われている症例は除外した。32眼に光凝固を追加し,24眼に緑内障手術を行った。最終的に34眼(85%)が薬物療法下で眼圧20mmHg以下にコントロールされた。20眼(50%)で0.1以上の最終視力が得られ,9眼(23%)が0.01未満であった。0.1以上の最終眼圧は,血管新生緑内障の発症時の眼圧が21mmHg以上の29眼中18眼(62%),20mmHg以下の11眼中2眼(18%)で得られ,有意差があった(p<0.05)。糖尿病網膜症患者に続発する血管新生緑内障に対しては,眼圧上昇の有無にかかわらず精力的に加療すべきである。
Abstract. Purpose:To review patients of diabetic retinopathy with neovascular glaucoma from clinical records in the past 6 years. Cases and Methods:We identified 40 affected eyes of 29 patients after excluding cases with no light perception and already operated cases. The series comprised 32 eyes of 22 males and 8 eyes of 7 females. Their ages ranged from 47 to 74 years,average 58 years. Results:Additional photocoagulation was performed on 32 eyes. Glaucoma surgery was performed on 24 eyes. Final intraocular pressure(IOP)below 20 mmHg was obtained in 34 eyes(85%)with or without medication. Final visual acuity was 0.1 or over in 20 eyes(50%). It was less than 0.01 in 9 eyes(23%). Final visual acuity was 0.1 or over in 18 out of 29 eyes(62%)with IOP over 21 mmHg at the onset of neovascular glaucoma and in 2 out of 11 eyes(18%)with IOP below 20 mmHg. The difference was significant(p<0.05). Conclusion:Eyes with high IOP at the onset of neovascular glaucoma result in better visual outcome than normotensive ones. Treatment ought to be started immediately after detection of neovasular glaucoma regardless of the level of IOP.
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