老人性円板状黄斑変性のレーザー光凝固最近3年間の成績

A three-year review of laser photocoagulation for senile disciform macular degeneration

　最近3年間の老人性円板状黄斑変性の色素レーザー光凝固治療成績をまとめた。症例は，術後少なくとも6か月以上経過観察が可能であった150例156眼であり，病型別に，視力・眼底所見を総合判定した。治療成績での改善率をみると，漿液性網膜剥離期（56眼）では57％，円板状病巣（48眼）では42％，網膜下血腫型（15眼）では53％，網膜色素上皮剥離型（37眼）では51％であった。全例での改善率は51％であった。前回の我々の治療成績と比較すると，全症例で改善率に大きい変化はなかったが，網膜色素上皮剥離型で改善率が著明に上昇した。これはICG蛍光眼底造影により隠れた脈絡膜新生血管が検出され．その光凝固後の好成緒によるものであった．

We treated 156 eyes of senile disciform macular degeneration with dye laser during the foregoing 3 years. All the cases were followed up for a minimum of 6 months, mean 16 months. The treatment was judged as success in 51% of the eyes. The rate of success was 57% in 56 eyes with serous retinal detechment, 42% in 48 with disciform lesion, 53% in 15 with subretinal hematoma, and 51% in 37 with detachment of retinal pigment epithelium, RPE. The current studies showed remarkable improvements in eyes with RPE detachment over our previous results from 1987 to 1990. This was mainly due to ICG angiography which contributed to better detection of occult choroidal neovascularizations. We also introduced ring-shaped photocoagulation in treating subfoveal neovascularizations. This technique induced better funduscopic results without improvement in visual acuity.