Optic nerve pitによる黄斑部網膜剥離に対する硝子体手術例

Vitreous surgery for macular detachment with pit in the optic disc

　Optic nerve pitに伴う黄斑部網膜剥離3例に対し，硝子体切除と眼内空気タンポナーデを施行した。2例は光凝固無効例で，1例は初回治療例であった。3例とも術前検査では後部硝子体剥離はなかった。水晶体後面から乳頭上まで硝子体を切除していくと，乳頭から黄斑部にかけて硝子体剥離が生じた。周辺部まで可能な限り硝子体を切除し，液空気置換を行った。術後は1週間程度腹臥位をとらせた。3例とも網膜剥離は消失した。本症の発症機序に硝子体による黄斑部網膜の牽引が考えられ，硝子体手術でそれを解除したために復位したと考えられた。

We treated 3 eyes with optic nerve pit and serous detachment of the macula by vitrectomy and intraocular air tamponade. The series comprised a 26-year-old female and 2 males aged 30 and 51 years each. Previous photocoagulation had proved futile in the first 2 cases. No posterior vitreousdetachment was present before or during surgery. After dissection of vitreous gel around the optic disc, we separated the posterior vitreous from the disc and the macula. Vitreous gel was excised except for the peripheral vitreous base. After sur-gery, the patients were kept in prone position for several days. The retina became reattached in all the 3 eyes. The findings suggest that serous detach-ment of the macula in this condition is related to vitreous traction and that vitrectomy with air tamponade is the logical therapeutic approach.