網膜静脈分枝閉塞症に続発した網膜剥離に対する硝子体切除の手術成績

Vitrectomy for retinal detachment following branch retinal vein occlusion

　網膜静脈分枝閉塞症に続発する網膜剥離8例の特徴と，それに対する硝子体切除の手術成績を検討し，報告した．

　全例裂孔を有する網膜剥離で増殖性網膜症を合併していた．裂孔はすべて網膜静脈分枝閉塞領域で赤道部より後極側に存在していた．

　手術はOcutomeの3 port systemで硝子体切除を行った後，7眼にシリコンオイルの眼内注入を行い，1眼は眼内に空気のみを注入し，3眼に輪状締結を併用した．

　術後全例に網膜の復位は得られたが，術後視力は0.7の1眼を除き，他は0.2以下であった．視力不良の原因として，硝子体出血による網膜剥離発見の遅延，網膜静脈分枝閉塞症による黄斑部変性が考えられた．

We treated eight eyes with rhegmatogenous retinal detachment which occurred as a late complication of branch retinal vein occlusion. In all the cases, retinal breaks were located within the capillary nonperfusion area and posterior to the equator. Proliferative retinopathy was present in all the eyes. Vitreous hemor-rhage was present in 4 eyes.

We treated all the eyes by pars plana vitrectomy using 3-port Ocutome system. Additional silicone oil injection into the vitreous was performed in 7 eyes. Scleral encircling procedure was performed in 3 eyes.

Anatomical reattachment of the retina was obtained in all the eyes. Final visual acuity was 0.2 or less. The poor visual outcome was due to delay in detection of retinal detachment due to vitreous hemorrhage and to macular involvement by branch retinal vein occlusion.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40 (8) : 955-959. 1986