網膜静脈分枝閉塞症に伴う黄斑浮腫に対するトリアムシノロン・テノン囊下注射の治療成績

Outcome of sub-Tenon injection of triamcinolone acetonide for macular edema in branch retinal vein occlusion

要約　目的：網膜静脈分枝閉塞症（BRVO）に伴う黄斑浮腫に対するトリアムシノロン・テノン囊下注射（STTA）の治療成績の報告。

対象と方法：過去6年間においてSTTA施行後3か月以上経過観察可能であった94例96眼。治療前後での術前および術後各時点での矯正視力（logMAR）と網膜厚（μm），術前および術後最高眼圧（mmHg）を後ろ向きに比較検討した。さらにSTTA治療前後の治療法について検討した。

結果：logMAR視力は術前0.38・術後24か月0.15（p＜0.01），網膜厚は術前550.5・術後24か月314.8（p＜0.01）であった。眼圧は術前14.7mmHg，術後最高17.1mmHg（p＝0.91）であった。術後眼内炎はなかった。STTAのみ（レーザー治療も含める）で治療可能できたものは67％を占めた。

結論：BRVOに伴う黄斑浮腫に対するSTTAは有効であり，重篤な合併症も少ない。

Abstract　Purpose: To report the outcome of sub-Tenon injection of triamcinolone acetonide（STTA）for macular edema secondary to branch retinal vein occlusion（BRVO）.

Cases and Method: This retrospective study was made on 96 eyes of 94 cases who received STTA for macular edema secondary to BRVO in the past 6 years. The series comprised 49 male and 47 female eyes. The age averaged 69.0±10.4 years. STTA was performed in 1 to 6 sessions, average 1.6 sessions. Cases were followed up for 3 months or longer. Visual acuity was evaluated as logMAR.

Results: Visual acuity averaged 0.38 before treatment and 0.15 24 months later. The difference was significant（p＜0.01）. Central retinal thickness averaged 550.5 μm before treatment and 314.8 μm 24 months later. The difference was significant（p＜0.01）. Intraocular pressure averaged 14.7 mmHg before treatment and maximally 17.1 mmHg after start of STTA. The difference was not significant（p＝0.91）. There was no case of endophthalmitis throughout. STTA alone or with adjunct laser treatment resulted in cure of BRVO and macular edema in 64 cases（67％）.

Conclusion: STTA was effective for macular edema secondary to BRVO. STTA resulted in lesser complications than other therapeutic modalities.