老人性円板状黄斑変性症の危険因子

Risk factors for age-related macular degeneration with choroidal neovascularization

　我々は，喫煙，高血圧症および血清脂質などの動脈硬化の危険因子と老人性円板状黄斑変性症との関連について，統計学的に検討した。対象は82例96眼の本症患者で，前述の因子について，一般人口との比較，1：1の患者対照研究および悪化例と瘢痕化例の比較を行った。その結果，喫煙が本症の発症および予後に危険因子として作用することが判明し，特に予後と過去の喫煙量との間に有意な関連を認めた。なお，血清脂質についても危険因子である可能性を示唆する結果が得られた。以上から，喫煙が本症の脈絡膜新生血管の発生および退縮に危険因子として関与していると結論した。

We evaluated the association between age-related macular degeneration (ARMD) with chor-oidal neovascularization and risk factors for ather-osclerosis.

A sample of 82 patients with hemorrhagic, exudative or disciform lesions was collected. The frequency of cigarette smokers differed significant-ly between our sample and general population. The estimated odds ratio was 2.31 (p<0.02). A dose-response relationship could be demonstratedbetween cigarette smoking and activity of neovas-cular membrane. In males in the 8th decade, total cholesterol levels and LDL-cholesterol levels of our sample increased significantly. In males in the 7th decade, HDL-cholesterol levels decreased signifi-cantly, compared with general population. No sig-nificant association was demonstrated between this disease and systemic hypertension.

The results suggested that cigarette smoking might stimulate the development of choroidal new vessels and inhibit the involution of neovascular membrane.