白内障術後に悪化をみた加齢黄斑変性に対する光線力学療法

Photodynamic therapy for exacerbation of age-related macular degeneration after cataract surgery

要約　目的：白内障手術後に悪化した加齢黄斑変性に対して行った光線力学療法の報告。症例：白内障手術から6か月以内に発症した滲出型加齢黄斑変性に対して光線力学療法を行い，1年以上の経過を観察した5例5眼を対象とした。男性4例，女性1例で，年齢は74～82歳（平均78歳）であった。発症から光線力学療法までの期間は，4例では4か月以内，1例では83か月後であり，術前視力は0.1～0.3であった。結果：視力は4例で改善し，1例で不変であった。光干渉断層計（OCT）で検索した4眼中3眼に不完全な後部硝子体剝離があった。結論：白内障手術後に発症した加齢黄斑変性に対し，光線力学療法は有効である。白内障手術による炎症と後部硝子体剝離が加齢黄斑変性を誘発した可能性がある。

Abstract.　Purpose：To report the outcome of photodynamic therapy（PDT）for age-related macular degeneration（AMD）that became manifest after cataract surgery. Cases：This retrospective study was made on 5 eyes of 5 patients. They received PDT for AMD that became manifest within 6 months after cataract surgery. The series comprised 4 males and 1 female. Their age ranged from 74 to 82 years, average 78 years. Four eyes received PDT within 4 months after onset of AMD and one eye after 83 months. Visual acuity before treatment ranged from 0.1 to 0.3. Results：After follow-up for one year or longer, visual acuity improved in 4 eyes and remained unchanged in one eye. Optical coherence tomography（OCT）showed posterior vitreous detachment（PVD）in 3 out of 4 examined eyes. Conclusion：PDT is effective for AMD that became manifest after cataract surgery. There is a possibility that AMD was induced by PVD and inflammation consequent to cataract surgery.