網膜血管病変に合併した加齢黄斑変性の臨床像

Clinical features of age-related macular degeneration with retinal vascular disorders

要約　目的：網膜血管病変に併発した滲出型加齢黄斑変性の頻度と臨床像の報告。対象と方法：2005年までの3年間の診療録を検索し，この期間に経験した網膜血管病変と滲出型加齢黄斑変性が併発した71例76眼を検討した。年齢が50歳以下，強度近視，脈絡膜炎などは除外した。結果：76眼の内訳は，糖尿病網膜症59眼，網膜静脈分枝閉塞症15眼，その他2眼であった。年齢は58～92歳（平均72歳）であり，男性50眼，女性26眼であった。50眼（62％）が狭義の加齢黄斑変性，24眼（32％）がポリープ状脈絡膜血管症，2眼（3％）が網膜内血管腫様増殖であり，これらの頻度は，同期間に経験した網膜血管病変を伴わない加齢黄斑変性969眼のそれと有意差がなかった。結論：糖尿病網膜症や網膜静脈分枝閉塞症などの網膜血管病変には高頻度で滲出型加齢黄斑変性が併発し，その臨床像は血管病変に併発しないそれと同様である。

Abstract.　Purpose：To report incidence and clinical features of age-related macular degeneration with retinal vascular disorders. Object and Method：During 3 years through 2005, 76 eyes of 71 patients were diagnosed with age-related macular degeneration associated with retinal vascular disorders. By definition, this study excluded eyes with high myopia, patients under 50 years of age, and choroidal inflammatory disorders. Results：The present cases comprised 50 males and 26 females. The age ranged from 58 to 92 years, average 72 years. The series included diabetic retinopathy 59 eyes, branch retinal vein occlusion 15 eyes, and other disorders 2 eyes. Fifty eyes（62％）had age-related macular degeneration in the narrow sense, 24 eyes（32％）had polypoidal choroidal vasculopathy, and 2 eyes（3％）had retinal angiomatous proliferation. The incidence was statistically the same with that of 969 eyes of age-related macular degeneration without retinal vascular disorders in the same period. Conclusion：Exudative age-related macular degeneration may be associated with retinal vascular disorders that include diabetic retinopathy and branch retinal vein occlusion. Its incidence is the same as that without retinal vascular disorders.