硝子体手術による乳頭周囲網膜神経線維層厚の変化

Changes in the thickness of retinal nerve fiber layer after vitreous surgery for macular hole or epiretinal membrane

要約　目的：黄斑円孔と網膜上膜に対する硝子体手術後の網膜神経線維層厚の変化の報告。対象と方法：過去2年間に手術を行った網膜上膜19眼と黄斑円孔21眼を対象とした。男性15眼，女性25眼で，年齢は46～78歳（平均66歳）であった。光干渉断層計で網膜神経線維層厚を測定した。結果：網膜神経線維層厚は術前103.5±19.2μm，術直後114.2±22.7μmであり，対応のあるt検定で有意に厚くなった（p=0.0003）。術後6か月未満，12か月未満，12か月以上では術前と変わらず，術後6か月以降では術直後よりも有意に薄くなった。結論：黄斑円孔と網膜上膜に対する硝子体手術では，網膜神経線維層厚が術直後に増大し，徐々に薄くなり術前値と同じになる。

Abstract.　Purpose：To report changes in the thickness of retinal nerve fiber layer（RNFL）after vitreous surgery for macular hole or epiretinal membrane. Cases and Method：This study was made on 21 eyes of macular hole and 19 eyes of epiretinal membrane who received surgery during the past 2 years. The series comporised 15 male and 25 female eyes. The age ranged from 46 to 78 years, average 66 years. Thickness of RNFL was measured by an optical coherence tomograph（OCT 3）. Results：RNFL thickness averaged 103.5±19.2μm before surgery and 114.2±22.7μm immediately after surgery. The difference was significant（p=0.0003）. It decreased gradually to approach the presurgical value when evaluated within 6 months, within 12 months or later after surgery. It became significantly thinner than the immediate postoperative value after 6 months of surgery. Conclusion：RNFL thickness increases immediately after surgery for macular hole or epiretinal membrane. It decreases to approximate the preoperative value after 6 months of surgery.