Aggressive posterior retinopathy of prematurityの臨床経過と治療成績

Clinical course and therapeutic outcome of aggressive posterior retinopathy of prematurity

要約　背景：未熟児網膜症の劇症型はⅡ型網膜症とされていた。2005年の新国際分類で，これはaggressive posterior retinopathy of prematurity（AP-ROP）と定義された。目的：AP-ROPの臨床経過と治療成績の報告。対象と方法：過去3年間にAP-ROPと診断した6例12眼を対象とした。結果：全例に光凝固を行った。光凝固の3.2週間後に網膜前出血が8眼に生じ，7.3週間後に牽引性網膜剝離が11眼に生じた。輪状締結術を4眼に行い，2眼で網膜が復位した。他の2眼と締結術をしなかった1眼に瘢痕期硝子体手術を行い，3眼とも復位しなかった。早期硝子体手術を行った6眼では5眼で復位が得られた。結論：AP-ROPは光凝固後も牽引性網膜剝離に進行した。牽引性網膜剝離には早期硝子体手術が有用であった。

Abstract.　Purpose：To report the outcome of treatment for aggressive posterior retinopathy of prematurity（AP-ROP）. Cases：This retrospective study was made on 12 eyes of 6 cases who were diagnosed with AP-ROP in the past 3 years. Results：All the eyes were treated by photocoagulation. Preretinal hemorrhage developed in 8 eyes after an average of 3.2 weeks. Traction retinal detachment developed in 11 eyes after 7.3 weeks. Four eyes were treated by scleral encircling. The retina became reattached in 2 eyes. The other 2 eyes and one eye that did not receive encircling received vitreous surgery after the retinopathy became cicatricial. All the 3 eyes failed to become reattached. Early vitreous surgery was performed on 6 eyes with traction retinal detachment. The retina became reattached in 5 eyes. Conclusion：Photocoagulation failed to prevent traction retinal detachment in eyes with AP-ROP. Early vitreous surgery promises to be of value in its prevention.