未熟児網膜症における網膜光凝固の斜視および弱視への影響

Incidence of strabismus and amblyopia as related to retinal photocoagulation for retinopathy of prematurity

要約　目的：未熟児網膜症（ROP）における網膜光凝固の斜視および弱視への影響の検討。

対象と方法：2006年1月〜2015年12月の間にROPと診断され，3年以上経過観察が可能であった46例（92眼）を対象とした。治療経過によって自然治癒群17例（34眼），半周光凝固群18例（36眼），全周光凝固群11例（22眼）に分類し，それぞれについて斜視および弱視発症への影響を検討した。

結果：斜視は自然治癒群で7例（41.2％），半周凝固群で4例（22.2％），全周凝固群で4例（36.4％）に発症した。弱視は自然治癒群で4例（23.5％），半周凝固群で3例（16.7％），全周凝固群で1例（9.1％）に認めた。斜視，弱視とも3群間で発症頻度に有意差はなかった。

結論：ROPにおいて斜視および弱視の発症に網膜光凝固の影響は少ないと考えられた。

Abstract　Purpose：To report the incidence of strabismus and amblyopia as related to retinal photocoagulation for retinopathy of prematurity（ROP）.

Cases and Method：A total of 402 newborn babies were diagnosed with retinopathy of prematurity during 10 years through 2015. This retrospective study was made on 46 cases who were followed up for 3 years or longer regarding the outcome of ROP. The series comprised 17 male and 29 female babies. They were born after gestation averaging 27.3±2.3 weeks and weighed 962±335 g at birth. Photocoagulation was performed, when needed, on both eyes using green laser with wavelength of 514 nm. Seventeen cases（34 eyes）received no photocoagulation, 18 cases（36 eyes）received 180-degree photocoagulation, and 11 cases（22 eyes）received 360-degree photocoagulation.

Results：Incidence of strabismus was 41％ in eyes that received no photocoagulation, 22％ in eyes that received 180-degree photocoagulation, and 36％ that received 360-degree photocoagulation. Incidence of amblyopia was 23.5％, 16.7％ and 9.1％ in the same order. There were no significant differences among the 3 groups regarding the incidence of strabismus or amblyopia.

Conclusion：Retinal photocoagulation did not influence the incidence of strabismus or amblyopia in the cicatricial stage of ROP.