網膜静脈本幹より硝子体出血を来したと思われる増殖性糖尿病性網膜症の1例

Vitreous hemorrhage from a major retinal vein in diabetic retinopathy

　増殖性糖尿病性網膜症の硝子体出血を数回繰り返し，硝子体手術を施行した例で偶然診察時硝子体再出血を捉えることができた．出血は後極部網膜静脈本幹より直接来したものと思われた．出血原因として硝子体手術時の血管の損傷，血管壁の脆弱化，微細な新生血管根部の断裂等が考えられる．

A 38-year-old male was diagnosed as pre-proliferative diabetic retinopathy. During the next 18 months, vitreous hemorrhage recurred in spite of panretinal laser photocoagulation. Both eyes were then treated by vitrectomy. On day 35 after vitrecotmy for the right eye, we could observe the sequence of acute rebleeding into the vitreous from its onset. The bleeding originated from the superiortemporal retinal vein, 3 disc diameters away from the disc.

The apparent hemorrhage directly from a major venous trunk seemed due to the following circum-stances. 1. The retinal vessels were more or less in a damaged state because of vitrectomy. 2. The retinal vessel wall was fragile due to diabetes. 3. A tiny neovascular membrane, attached to the vein at the site of bleeding, exerted truction and damage to the parent vessel.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(12) : 1312-1314,1987