特発性黄斑部網膜上膜形成症の手術成績と組織検索

Surgical removal of idiopathic epiretinal membrane and their pathological findings

　進行性の特発性網膜上膜形成症4例4眼に対し，硝子体手術により，増殖膜の剥離および切断を行い，合併症の発生はなく，全例で眼底所見の改善および視力の向上を見た．最低6カ月最長1年9カ月の観察期間で，上膜の再発傾向を認めたものは1例のみであった．2例について切除した膜の電顕的観察を行い，astrocyteと思われる細胞，線維芽細胞，硝子体細胞などの細胞成分と，膠原線維や基質から構成されていた．リンパ球も認められ，網膜上膜形成に炎症の関与が推測された．

We treated 4 eyes in 4 patients with progressive idiopathic epiretinal membrane formation by pars plana vitrectomy applying membrane peeling, seg-mentation and delamination. All cases developed no complications during surgery. The retinal traction could be released, the cystoid macular edema sub-sided, and the visual acuity was improved in all the cases.

During the follow-up period ranging 6 to 21months, only one eye developed minimal recurrence of epiretinal membrane. The excised membrane material was examined in 2 cases. We found fibro-blasts, hyalocytes, and astrocytic cells enmeshed in collagen fiber and the ground substance. In one of the cases, we found lymphocytes in the epiretinal membrane, suggesting that an inflammatory pro-cess might be taking part in the epiretinal mem-brane formation.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(5) : 529-533, 1987