網膜静脈分枝閉塞症に伴う硝子体出血に対する硝子体手術の成績

Results of vitreous surgery for vitreous hemorrhage secondary to branch retinal vein occlusion

要約　目的：網膜静脈分枝閉塞症（BRVO）発症後の硝子体出血に対し硝子体手術を行った症例から，手術成績と網膜光凝固（PC）の必要性について検討した。

対象と方法：対象は2013年4月〜2018年3月に自治医科大学眼科でBRVO発症後に硝子体出血を生じた眼に対し硝子体手術を施行した46例46眼。術前PCの有無，術前・術後視力，術後視力と術前PCの有無，無血管野の部位と術後視力，術中・術後合併症について後ろ向きに検討した。

結果：硝子体手術前に31例（67％）でPCが施行されていた。術後視力1.0以上は29例（63％）で得られた。術前PCの有無と術後視力との間には関連はなく，網膜血管アーケード内に無血管野があるものでは術後視力が不良であった。術中・術後合併症は10例にみられた。

結論：術前にPCが施行された症例が多かったが，術後視力は良好であった。術前PCの有無は術後視力に影響はなかった。PCの必要性についてはさらに検討が必要と考えられた。

Abstract　Purpose：To report the results of vitreous surgery for vitreous hemorrhage（VH）after branch retinal vein occlusion（BRVO）and the validity of retinal photocoagulation（PC）before sugery.

Cases and Methods：Forty-six eyes of 46 cases received vitreous surgery for VH due to BRVO from April 2013 to March 2018 at Jichi Medical University. We reviewed the presence or absence of preoperative PC, preoperative and postoperative best-corrected visual acuity（BCVA）, relationship between postoperative BCVA and preoperative PC, relationship between non-perfusion area and postoperative BCVA, and intraoperative and postoperative complications.

Results：PC had been performed in 31 eyes（67％）before surgery. Postoperative BCVA of 1.0 or more was obtained in 29 eyes（63％）. There was no relationship between the presence or absence of preoperative PC and postoperative BCVA. Postoperative BCVA was poor if there was non-perfusion area in the macula. Intraoperative complications and postoperative complications were found in 10 cases respectively.

Conclusion：Many eyes had received PC before surgery and postoperative BCVA was satisfactory. The presence or absence of preoperative PC had no effects on postoperative BCVA. The validity of PC before surgery should be investigated further.