網膜静脈閉塞症と緑内障との合併

Association of retinal vein occlusions with glaucoma

　網膜静脈閉塞症に緑内障は合併しやすいと欧米では報告されている．本邦では網膜静脈閉塞症にどの様な緑内障が合併し，どの様な特徴があるのかを最近2年間の当科の患者について調査した．

　網膜静脈閉塞症患者は367例あり，その28例に緑内障の合併を認め，網膜中心静脈閉塞症の17％，網膜静脈分枝閉塞症の6％に緑内障の合併を認めた．原発性開放隅角緑内障（POAG）が9眼，高眼圧症が3眼，網膜静脈閉塞症から緑内障が続発した新生血管緑内障が7眼，続発性閉塞隅角緑内障が4眼溶血性緑内障が2眼，硝子体出血に対する硝子体白内障手術後の緑内障が3眼あった．POAGは網膜静脈閉塞症の3.3％に合併を認め，逆にPOAGの2.8％に網膜静脈閉塞症の合併をみた．網膜静脈閉塞症の閉塞部位による発生頻度の違いを認めなかった．新生血管緑内障は網膜中心静脈閉塞症に13.2％と高率に続発し，発症後3〜6カ月に多く発生した．他にも色々な緑内障の合併を認め，いずれも治療開始が遅れると観血的手術療法を用いても眼圧の調整が難しいので，網膜静脈閉塞症と診断された患者については，常に緑内障の合併に留意しなければならない．

We evaluated a consecutive series of 367 cases with retinal vein occlusions seen during the fore-going 2 years with particular attention to the pres-ence of glaucoma.

Glaucomas were found 28 cases (7.4%) in the whole series. The incidence was 17% in 53 cases with central vein occlusion and 6.0% in 314 cases with branch retinal vein occlusion.

Various types of glaucoma were involved in the detected 28 cases : primary open angle glaucoma 9cases, ocular hypertension 3 cases, neovascular glaucoma 7 cases, secondary angle closure glau-coma 4 cases, hemolytic glaucoma 2 cases, and glaucoma following vitrectomy 3 cases.Branch retinal vein occlusion was related to all types of glaucoma. Central retinal vein occlusion was mainly related to neovascular and secondary angle closure glaucomas.

Primary open angle glaucoma was present in 3.3% of the whole series, 3.8% in central retinal vein occlusion and 3.2% in branch occlusion. Patients with retinal vein occlusion have a higher risk for glaucoma as associated or secondary lesions.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(6) : 677-680, 1987