特発性黄斑上膜にみられる血管周囲異常所見の術後変化

Changes in abnormal paravascular findings following surgery for idiopathic epiretinal membrane

要約　目的：特発性黄斑上膜（ERM）にみられる血管周囲異常所見の術後変化の報告。

対象と方法：対象は当院で硝子体手術を行ったERM症例9例9眼。術前後に青色単色光撮影と光干渉断層計を用いて血管周囲異常所見の変化を検討した。手術は全例内境界膜剝離を併用した硝子体切除を行った。

結果：術前，血管周囲に網膜内層孔が9眼中7眼に，血管周囲囊胞が9眼中4眼に観察された。術後7眼中7眼で網膜内層孔が消失したが，内層孔が深い1例は陥凹が軽減するにとどまった。血管周囲に囊胞がみられた4眼中3眼で囊胞が消失した。

結論：黄斑上膜症例の血管周囲にみられる網膜内層孔と囊胞は，接線方向の牽引が成因の1つであると考えられた。

Abstract　Purpose: To report changes in abnormal paravascular findings following surgery for idiopathic epiretinal membrane.

Cases and Method: This retrospective study was made on 9 eyes of 9 cases who received surgery for idiopathic epiretinal membrane. The series comprised 4 males and 5 females. The age averaged 71.2±6.3 years. All the eyes were evaluated by blue monochromatic photography and optical coherence tomography（OCT）before and after surgery.

Results: Before surgery, 7 eyes showed holes in the inner retinal layer along major vessels. Paravascular cysts were present in 4 eyes. After surgery, holes in the inner retinal layer disappeared in 6 eyes and became shallow in one eye. Paravascular cysts disappeared in 3 out of 4 eyes.

Conclusion: Many eyes with idiopathic epiretinal membrane showed holes in the inner retinal layer and paravascular cysts. The holes and cysts disappeared or became less distinct after surgery in the majority of cases. The holes and cysts seemed to be due to tangential traction to the retina by the epiretinal membrane.