糖尿病黄斑浮腫に対する硝子体手術

Vitrectomy for diabetic macular edema

　糖尿病網膜症の病態のうち黄斑浮腫は視力低下の原因として頻度が高い。最近，糖尿病黄斑浮腫の病態に後部硝子体膜の牽引の関与が指摘されている。筆者らは後部硝子体膜の牽引が考えられる糖尿病黄斑浮腫5症例5眼に対し硝子体手術を行い，黄斑部にかかる牽引の解除を試みた。手術後5症例全眼で解剖学的な浮腫の減少，視力の改善が得られ，黄斑部への牽引が考えられる糖尿病黄斑浮腫に対する硝子体手術の有効性が示唆された。

We performed vitrectomy on 5 eyes of diabetic macular edema associated with traction of posterior hyaloid membrane. Prior to surgery, all patients showed thickening of posterior hyaloid membrane by biomicroscopy. Fluorescein angiography showed diffuse dye leakage. All eyes had undergone previous panretinal photocoagulation. The surgery consisted of lifting and removal of posterior hyaloid membrane from the retina. Improvement in visual acuity resulted in all the eyes. The macular edema resolved in 3 eyes and decreased in 2. Pars plana vitrectomy with separation of the posterior hyaloid membrane thus appeared to be beneficial for diabetic macular edema associated with vitreous traction.