色素レーザーによる老人性円板状黄斑変性症の治療成績

Dye laser photocoagulation for senile disciform macular degeneration

　老人性円板状黄斑変性症45例45眼に対して，色素レーザーによる光凝固治療を行った．波長特性による理論，ならびに我々の行った動物実験成績より，本症の網膜下新生血管の凝固閉塞には，色素レーザーの590nm橙色波長が最適と考えられ，この波長を主として用いた．平均観察期間は6.5カ月で，全例の視力向上率は51％であり，眼底所見を含めた総合判定の成績では全例の71％に改善をみた．特に本症初期の漿液性網膜剥離期の症例15眼には87％に改善をみた．

　波長可変性と凝固組織の選択性を利用することにより，色素レーザーは，今後本症の光凝固療法に，きわめて有用な治療手段となりうることが示された．

We treated 45 eyes with senile disciform macular degeneration by means of organic dye laser. The series included serous retinal detachment type 15 eyes, subretinal hematoma type 10 eyes, subretinal cystic type 2 eyes and subretinal fibrous prolifera-tion 18 eyes. We elected only eyes in which the subretinal neovascularization was located 200 gm or more from the central fovea.

We mainly applied orange beam of 590 nm wave-length to directly obliterate the subretinal neovas-cularization. The patients were followed up for 4 months at least, average 6.5 months. Improvement in visual acuity resulted in 23 eyes (51%). The funduscopic findings were judged as successful in 32 eyes (71%). The treatment with dye laser was particularly beneficial in the early stage of sub-retinal neovascularization manifesting serous retinal detachment.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(2) : 121-125, 1988