小児の網膜剥離

Retinal detachment in children

　最近6年間に関西医大眼科で手術を行った網膜剥離症例のうち，15歳以下の37例43眼について検討した．男性が79％と多く，さらに外傷性網膜剥離では圧倒的に男性が多かった．原因として鈍傷が重要で，特にボール外傷が多く見られた．瘢痕期未熟児網膜症による晩発性剥離や硝子体網膜変性症の症例では，剥離は重篤で手術は輪状締結術を必要とし，復位しても視力回復は不良例が多かった．成人に見られる格子状変性円孔型網膜剥離の早期発生例と思われる症例も多かった．手術を確実に行うと，手術による網膜の復位成績は良好であったが，陳旧例や他の眼合併症を伴ったものでは視力回復は不良であった．小児網膜剥離を取り扱う上で，早期発見が重要と思われた．

We treated 43 eyes with retinal detachment in 37 cases under 15 years of age during the foregoing 6 years. Males constituted 78% of series. Retinal detachment was induced by blunt trauma in 19 eyes (44%), of which 18 were males. Retinopathy of prematurity in its cicatricial phase was the cause of detachment in 4 eyes. Vitreoretinal dystrophy was involved as the underlying cause in 5 eyes. In both instances, retinal detachment was in serious state so as to necessitate encircling surgical proce-dure. Further, the postsurgical visual acuity was generally poor in these cases despite anatomical reattachment of the retina.

In the present series of 43 eyes, the outcome of retinal detachment surgery was favorable in general. Poor recovery of visual acuity was the rule in complicated cases or in those with delayed surgery. Early detection is thus essential in the management of retinal detachment in children.