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要約 目的:あけお眼科医院に来院する裂孔原性網膜剝離(RRD)患者の症状,臨床所見,受入れ先医療機関からの情報を調べ,手術方法,手術までの期間,術前術後の視機能〔矯正視力(視力),ハンフリー視野検査(HFA)〕について検討した結果の報告。
対象と方法:過去185か月間に受診した34症例を解析した。男性26例,女性8例,年齢は12〜68歳(平均46歳)であった。
結果:主な自覚症状は,視野欠損17例(50.0%),飛蚊症のみ8例(23.5%)であり,発症から診断まで平均6.9日であった。患眼は右24例(70.6%),左10例(29.4%)。裂孔形状は萎縮円孔10例(29.4%),円孔4例(11.8%),馬蹄形裂孔16例(47.1%)であり,位置は上耳側16例(47.1%),下耳側9例(26.5%)であった。網膜剝離の範囲は1象限19例(55.9%),2象限8例(23.5%)であった。27例(79.4%)の受入れ先医療機関からの報告では,診断から加療まで平均4.0日であり,光凝固のみ8例(29.6%),バックリング7例(25.9%),硝子体手術11例(40.7%)であった。経過観察は24例(70.6%)(HFA 12例)に可能であった。術前術後の比較では,視力は0.4以下の症例は術前8例(33.3%)が術後2例(8.3%)に,1.0以上は術前11例(45.8%)が術後16例(66.7%)になった。HFAのMD値の平均は術前−11.9dBが術後−4.0dBと回復した。
結論:自覚症状発現後早期に来院し,迅速に加療が行われたRRD患者では視機能の回復が認められ,他の医療機関との密接な連携が重要であると思われた。
Abstract Purpose:To report the present status of patients with retinal detachment(RD)in Akeo Eye Clinic(AEC)about symptoms, findings, and information from hospitals.
Cases and Methods:This retrospective study included 34 patients with RD during the past 185-month period. The series comprised 26 men and 8 women. Patient's age ranged from 12 to 68 years, with an average of 46 years, at diagnosis. Visual acuity(VA)and visual field with Humphrey field analyzer(HFA)were examined.
Results:The average time from symptoms such as visual field defect of 17(50.0%)and floaters of 8(23.5%)patients to diagnosis was 6.9 days. In the right 24(70.6%)and left eyes 10(29.4%)of cases, there were round holes of 14(41.2%)and horse-shoe shaped tears of 16(47.1%)cases located at superior in 16(47.1%)and inferior temporal quadrants in 9(26.5%)patients. RD was one quadrant in 23(67.6%)and two quadrants in 8(23.5%)patients. The average time between diagnosis and treatment was 4 days. Treatment by photocoagulation, buckling, and vitreous surgery was performed in 8(29.6%), 7(25.9%), 11(40.7%)patients, respectively. In 24(70.6%)patients followed by AEC after treatment, the patients with VA less than 0.4 decreased from 8(33.3%)into 2(8.3%)and those with VA more than 1.0 increased from 11(45.8%)into 16(66.7%). The average of MD values of HFA recovered from −11.9 dB to −4.0 dB.
Conclusions:Consultation after symptoms and treatment after diagnosis of RD as early as possible resulted in recovery of visual function. We suggested that cooperation with the other hospital was important.
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