増殖糖尿病網膜症に伴う黄斑浮腫に対する硝子体手術成績

Surgical results of pars plana vitrectomy for macular edema associated with proliferative diabetic retinopathy

　1987年1月〜1993年6月に増殖糖尿病網膜症に対して初回硝子体手術を施行した23例25眼を対象とし，術前後での視力と黄斑部螢光造影所見を比較検討した。術後3か月での視力は，改善13眼52％，不変7眼28％，悪化5眼20％であった。黄斑部螢光造影所見では改善12眼60％，不変7眼35％，悪化1眼5％であった。全身諸因子については有意差を認めたものはなかった。硝子体手術は増殖糖尿病網膜症に伴う黄斑浮腫の改善に有効であり，硝子体は黄斑浮腫形成に何らか関与していると考えられた。

To clarify the efficiency of vitrectomy for diabetic macular edema, we investigated the visual acuity and the fluorescein angiographic findings of pre-and post-vitrectomy on 25 eyes of 23 patients with proliferative diabetic retinopathy from January, 1987 to June, 1993 retrospectively. 3 months after vitrectomy, visual acuity was improved in 13 eyes (52%) deteriorated in 5 eyes (20%), and unchanged in 7 eyes (28%). The fluorescein angiographic findings were improved in 12 eyes (60%), worsened in 1 eye (5%), and stable in 7 eyes (35%). There was no relation between any systemic factors and macular edema during the following period.

In conclusion, we suggested that vitrectomy was effective to improve the macular edema of patients with proliferative diabetic retinopathy, and the vitreous may play a role in developing macular edema.