短照射小スポット汎網膜光凝固の長期成績

Long-term outcome of small-spot short-duration panretinal photocoagulation for diabetic retinopathy

要約　目的：糖尿病網膜症に対する短照射小スポット汎網膜光凝固の長期成績の報告。症例と方法：汎網膜光凝固を行った糖尿病網膜症15例29眼を対象とした。男性7例，女性8例で，年齢は47～75歳（平均67歳）で，糖尿病網膜症は軽症25眼，重症4眼であった。光凝固には緑色レーザーを用い，照射時間は0.1秒，凝固斑は100μm，出力は0.08～0.12Wに設定した。1回に約200発，総計1,500～2,000発の凝固斑を置いた。術後1年以上の経過を追った。結果：3例5眼で小数視力が2段階以上低下した。うち2例4眼では汎網膜光凝固から1年以上後に黄斑浮腫が増悪し，他の1眼では白内障が進行した。これ以外の症例では視力が維持された。結論：糖尿病網膜症に対する短照射小スポット汎網膜光凝固は，1年後の評価でほぼ有効であった。

Abstract.　Purpose：To report the outcome after one year of small-spot, short-duration panretinal photocoagulation for diabetic retinopathy. Cases and Method：This retrospective study was made on 29 eyes of 15 patients with diabetic retinopathy. The series comprised 7 males and 8 females. The age ranged from 47 to 75 years, average 67 years. Diabetic retinopathy was mild in 25 eyes and severe in 4 eyes. Photocoagulation was performed with green laser, applied for 0.1 second each, 100μm as spot size, and the output was set between 0.08 and 0.12W. Each eye received about 200 burns at one session and a total of 1,500 to 2,000 burns. Cases were followed up for one year or longer. Results：Visual acuity decreased by 2 lines or more in 5 eyes of 3 patients. The decrease was due to macular edema in 4 eyes of 2 patients that developed more than one year after treatment. Cataract developed in one eye. Visual acuity was maintained in the remaining 24 eyes. Conclusion：Small-spot, short-duration panretinal photocoagulation was effective for diabetic retinopathy in the present series.