Stage分類を用いた特発性黄斑円孔の手術予後の検討

Outcome of surgery for idiopathic macular hole as related to its stage after Gass

要約　目的：特発性黄斑円孔の手術成績をその病期と連関して評価すること。症例と方法：過去39か月間に手術を行った特発性黄斑円孔94例103眼を検索した。光干渉断層計（OCT）を使い，Gassの新分類に基づいて病期を判定した。術後視力で手術の成績を評価した。結果：黄斑円孔の病期は，stage 1が1眼，stage 2が44眼，stage 3が25眼，stage 4が23眼であった。病期別の術後相乗平均視力は，stage 1が0.8，stage 2が0.66，stage 3が0.5，stage 4が0.32であり，病期と術後視力との間に有意な相関があった（p＜0.005，ANOVA）。結論：Gassによる特発性黄斑円孔の新分類は臨床病理学的な面を反映し，術後視力の推定に有用である。

Abstract.　Purpose：To evaluate the outcome of surgery for idiopathic macular hole as related to its stage after Gass. Cases and Method：This retrospective study was made on 103 eyes of 94 cases of idiopathic macular hole that received surgery during the past 39 months. Optical coherence tomography（OCT）was used to classify the macular hole in accordance to the new classification by Gass. The outcome of surgery was evaluated using visual acuity as a parameter. Results：The present series comprised stage 1 one eye,stage 2 44 eyes,stage 3 25 eyes,and,stage 4 23 eyes. Median of final visual acuity was 0.8 for stage 1,0.66 for stage 2,0.5 for stage 3,and 0.32 for stage 4. Postoperative visual acuity was significantly correlated with the staging（p＜0.005,ANOVA）. Conclusion：Staging of macular hole by Gass reflects the clinicopathological aspects of the disease. It may be of use to estimate the probable outcome of surgery.