網膜色素線条症における黄斑部合併症について

Involvement of the macula in angioid streaks

　過去13年間に網膜色素線条症と診断された23例46眼中，黄斑部合併症（黄斑部網膜下新生血管）を有した11例20眼（43.5％）を検討した。症例は男性7例14眼，女性4例6眼で，全例40歳以上で，50〜60歳代が81.8％を占めた。黄斑部合併症を有する群と有さない群との間で，弾力線維性仮性黄色腫およびpeau d'orange，salmon spots等の眼底所見の合併率に差はなかった。黄斑部合併症群の10例17眼85％に，螢光眼底造影でhypofluorescent dotsを黄斑部耳側あるいは乳頭周囲に認め，その程度はhypofluorescent dotsのみを示すものから，dotsの周囲にhyperfluorescenceを呈するものまでさまざまであった。本所見は検眼鏡的にはほとんど認められず，螢光眼底造影でのみ観察された。光凝固で4例6眼は瘢痕化したが，2例2眼は新生血管が増大し，視力は悪化もしくは不変であった。

In a series of 23 cases of angioid streaks, we detected submacular neovascularization in 20 eyes, 11 patients. The macular complication occurred after the age of 40. Fluorescein angiography showed hypofluorescent dots scattered over the macula and around the optic disc in 17 of these 20 eyes. The dots did not correlated with the peau d' orange lesions. In some, each dot was surrounded by a ring of hyperfluorescence.

We treated 8 eyes with neovascular membrane in the macula with the use of bluegreen or green argon laser, red krypton laser, or dye laser. Two or more laser sessions were necessary in 6 of the 8 eyes. Obliteration of subretinal neovascular membrane was possible in 6 eyes associated with large chorioretinal scars. Subretinal neovascular membrane increased in size in the other 2 eyes. Visual acuity either remained stationary or deteriorated during the follow-up period of 7 months to 11 years, average 5.6 years.