老人性円板状黄斑部変性症の光凝固後に生じた網膜色素上皮裂孔の2例

Tears in retinal pigment epithelium developed in two eyes after photocoagulation for age-related macular degeneration

　老人性円板状黄斑部変性症の光凝固治療後に網膜色素上皮裂孔を生じた2例を経験した。今までの報告では裂孔は網膜色素上皮剥離辺縁に生じるものがほとんどであるが，今回は漿液性網膜剥離辺縁および漿液性網膜色素上皮剥離をやや超えて発生した。本症は網膜色素上皮に強い接線方向の牽引がかかって発生するものといわれており，大きいあるいは脈絡膜新生血管を伴う網膜色素上皮剥離の強度な光凝固は避けるべきと考える。

We treated 2 eyes with age-related disciform macular degeneration by red krypton laser. Serous detachment of the sensory retina with subretinal hemorrhage was the prominent feature in one eye and serous detachment of the retinal pigment epith-elium in the other. Choroidal neovascularization was present in both eyes. A pigment epithelial rip appeared along the border of the serous retinal detachment in the first case and within the serous pigment epithelial detachment in the second. The number of photocoagulation bursts amounted to 403 and 87 each. Large size of choroidal neovas-cularization and intense photocoagulation seemed to be the contributory factors for development of tear in the pigment epithelium.