加齢黄斑変性の脈絡膜新生血管部の眼底自発蛍光

Fundus autofluorescence of age-related macular degeneration with choroidal neovascular membrane

要約　目的：加齢黄斑変性の脈絡膜新生血管部からの眼底自発蛍光の報告。症例と方法：加齢黄斑変性16眼を対象とした。男性10眼，女性6眼で，平均年齢は72歳である。15眼にラニビズマブ，1眼にベバシズマブと光線力学療法を行った。眼底自発蛍光はキャノンCX-1で記録した。結果：脈絡膜新生血管がある部位の自発蛍光は14眼で低下していた。光干渉断層計（OCT）で，網膜色素上皮を越えた脈絡膜新生血管が7眼にあり，うち6眼では脈絡膜新生血管が低自発蛍光の部位と一致した。6眼でのOCTで網膜色素上皮が不明瞭な部位にも，低自発蛍光がみられた。結論：脈絡膜新生血管の部位で自発蛍光が低下する原因は，新生血管そのものによる遮断と考えられるが，網膜色素上皮の障害も関与している。

Abstract.　Purpose：To report fundus autofluorescence in eyes of age-related macular degeneration（AMD）with choroidal neovascular membrane（CNV）. Cases and Method：This study was made on 16 eyes with AMD and CNV. The series comprised 10 male and 6 female eyes. The age averaged 72 years. Ranibizumab was used in 15 eyes. One eye received bevacizumab and photodynamic therapy. Fundus autofluorescence was recorded by a Canon CX-1 fundus camera. Results：Site of CNV corresponded with decreased fundus autofluorescence in 14 eyes. In 7 eyes,the extent of CNV was larger than that of retinal pigment epithelium（RPE）when seen by optical coherence tomography（OCT）. The site of CNV was the same in 6 of these eyes when seen by OCT and fundus autofluorescence. Six eyes showed decreased fundus autofluorescence in areas with indistinct RPE as seen by OCT. Conclusion：Decreased fundus autofluorescence has been attributed to blocking by CNV but may also be due to impaired RPE.