ポリープ状脈絡膜血管症における光線力学療法後に増加した出血に関する検討

Increase of hemorrhage following photodynamic therapy for polypoidal choroidal vasculopathy

要約　目的：ポリープ状脈絡膜血管症に対する光線力学療法後に生じる出血増加の検討。対象：過去31か月間に光線力学療法を行い，6か月以上の経過観察ができた72例74眼を対象とした。男性53例，女性19例で，年齢は52～87歳（平均73歳）である。結果：10眼（14％）で出血が増加した。出血の増加は，抗凝固薬の使用と中心窩厚の変化が相関し，性別，年齢，治療までの期間，病巣の最大径，術前の視力，網膜色素上皮剝離の大きさ，出血の大きさ，術前の中心窩厚は出血の増加とは相関しなかった。結論：ポリープ状脈絡膜血管症に対する光線力学療法後に生じる出血の増加は，中心窩厚の減少が少ない例と抗凝固薬の全身投与例で起こりやすい。

Abstract.　Purpose：To report factors related with increase of hemorrhage following photodynamic therapy for polypoidal choroidal vasculopathy. Cases：This retrospective study was made on 74 eyes of 72 patients who received photodynamic therapy in the past 31 months. The series comprised 53 males and 19 females. The age ranged from 52 to 87 years,average 73 years. Cases were followed up for 6 months or longer. Results：Hemorrhage increased in 10 eyes（14％）after treatment. Postoperative hemorrhage was correlated with change in foveal thickness and use of systemic anticoagulant agents. It was not correlated with sex,age,interval between onset and treatment,maximal size of fundus lesion,visual acuity,size of retinal pigment epithelial detachment,size of hemorrhage,or preoperative foveal thickness. Conclusion：Hemorrhage after photodynamic therapy is prone to occur in eyes with lesser decrease in foveal thickness and in cases treated by systemic anticoagulant agent.