加齢性黄斑変性に対する連続波Nd：YAGレーザー光凝固の治療成績

Photocoagulation with continuous Nd:YAG laser to age-related macular degeneration

　1986年1月から1993年12月まで防衛医科大学校病院眼科を受診し加齢性黄斑変性と診断された患者282例，314眼に対し，連続波Nd：YAGレーザー光凝固を行い，この治療成績を検討した。光凝固適応100眼のうち光凝固施行は58眼であった。観察期間は3か月から120か月で，加齢性黄斑変性の病型は宇山分類に準拠した。光凝固施行群の視力悪化例は，漿液性網膜剥離期23.50％，網膜下結合織増殖型37.0％，網膜下血腫型50.0％網膜下嚢胞型50.0％であった。漿液性網膜剥離期が最もよく光凝固に反応したが，1／3〜3乳頭径大の網膜下新生血管板が中心窩にかかるか，中心窩より1／2乳頭径以内の距離の症例は光凝固無効であった．

We reviewed the outcome of photocoagulation with continuous Nd: YAG laser for age-related macular degeneration (ARMD) during the foregoing 13 years. ARMD was diagnosed in 314 eyes, 282 patients. Photocoagulation was performed in 58 eyes out of 100 eyes indicated for treatment. After a follow up for 3 months to 10 years, visual acuity deteriorated in 24% in eyes with serous retinal detachment, in 37% with subretinal fibrosis, in 50% with subretinal hemorrhage and in 50% with subretinal cyst. Eyes with serous retinal detachment responded most favorably to the treatment. Photocoagulation was ineffective when subretinal neovascular tissue was larger than one-third disc diameter and located within one-half disc diameter from the foveola.