増殖糖尿病網膜症における房水フレア値の検討

Quantitation of aqueous flare in proliferative diabetic retinopathy

　増殖糖尿病網膜症の房水フレア値をレーザーフレアセルメーター（FC-1000^®，興和）で測定した。増殖糖尿病網膜症を臨床的重症度に応じて分けると，汎網膜光凝固で網膜症が鎮静化したA群12眼，硝子体出血あるいは黄斑外牽引性網膜剥離が存在し網膜症の活動性が高いB群9眼，高度の硝子体出血あるいは黄斑牽引性網膜剥離が存在し硝子体手術予定例であるC群37眼であった。またコントロールとして正常眼12眼を用いた。各群の房水フレア値（photon couts/msec）は，A群11.6±4.9，B群16.1±4.5，C群38.6±58.8，正常群4.0±0.8であり，各群間のすべてに統計学的有意差を認めた。房水フレア値測定は糖尿病の細小血管症及び新生血管による血液眼関門の異常を捉えるために有用な検査法であり，増殖糖尿病網膜症の管理に有用であると考えられる。

We quantitated the intensity of aqueous flare in 58 eyes of 42 patients with proliferative diabetic retinopathy using an aqueous flarecell meter. The eyes were graded into 3 groups based on the severity of retinopathy. Group A was quiescent retinopathy treated by panretinal photocoagulation. Group B was active retinopathy with vitreous hemorrhage or extramacular tractional retinal detachment. Group C was vitrectomy candidates with severe vitreous hemorrhage or tractional retinal detachment in the macula. Intensity of aqueous flare, expressed as photon counts/msec, averaged 11.6±4.9 in group A, 16.1±4.5 in group B and 38.6±58.8 in group C. The flare intensity and severity of retinopathy was significantly correlated. Aqueous flare intensity seemed to reflect the status of bloodretinal barrier in eyes with diabetic microangiopathy. This method promises to be of value in determining the indication for vitrectomy in proliferative diabetic retinopathy.