網膜血管腫に対して硝子体手術を施行した4例

Four cases of retinal capillary hemangioma treated by pars plana vitrectomy

要約　目的：網膜血管腫に対して硝子体手術を行った4例の報告。症例：過去5年間に網膜血管腫とその合併症に対して硝子体手術を行った4例4眼を診療録の記載に基づいて検索した。男性1例と女性3例で，年齢は36，50，52，55歳であった。所見と経過：網膜血管腫は3眼では血管増殖性腫瘍（vasoproliferative tumor），1眼ではvon Hippel病であった。いずれも孤立性で，網膜赤道部にあり，大きさは2～4.5乳頭径であった。4眼に網膜剝離，2眼に黄斑上膜が併発した。2眼に流入血管の光凝固，2眼に経瞳孔的温熱療法を行い，その後，硝子体手術による眼内ジアテルミーを3眼，血管腫の部分切除を2眼，全切除を1眼に実施した。網膜は全例で復位し，ジアテルミーのみの1眼では血管腫が再発した。結論：網膜血管腫に対して，腫瘍の部分切除が奏効することがある。

Abstract.　Purpose：To report 4 cases of retinal capillary hemangioma treated by pars plana vitrectomy. Cases：Four cases were treated for complications of retinal capillary hemangioma in the past 5 years. The series comprised one male and 3 females and were aged 36, 50, 52 and 55 years respectively. All were unilaterally affected. Findings：Retinal capillary hemangioma was identified with vasoproliferative tumor in 3 cases and with von Hippel disease in one. The hemangioma was solitary in all the cases and was located in the equator. Its size was between 2 and 4.5 disc diameters. Retinal detachment developed in 4 eyes and epiretinal membrane in two. Photocoagulation of feeding vessels was applied in 2 eyes and transpupillary thermotherapy in 2 eyes. All the eyes then received vitrectomy with intraocular diathermy in 3 eyes, partial resection in 2 eyes, and total resection in one. The retina became reattached in all the 4 eyes. Hemangioma recurred in one eye that was treated by diathermy only. Conclusion：The present cases show that partial resection may be effective for retinal capillary hemangioma.