網膜静脈分枝閉塞症の合併症に対する硝子体手術

Vitreous surgery for complications of branch retinal vein occlusion

　網膜静脈分枝閉塞症に続発した硝子体出血、裂孔原性網膜剥離、牽引性網膜剥離に対して硝子体手術を施行した40例40眼の手術成績について検討した。牽引性網膜剥離は硝子体出血を長期間放置していた症例に多くみられた。術中合併症は医原性網膜裂孔のみで牽引性網膜剥離例の4眼において増殖膜処理の際に生じた。術後網膜剥離は4眼に認め，3眼は鋸状縁断裂、1眼は医原性網膜裂孔によるものであった。視力は85％の症例で改善し，最終視力0.5以上が60％と比較的良好であったが，牽引性網膜剥離例では視力不良例が多かった。以上の結果より，吸収不良の硝子体出血例では早期に硝子体手術を考慮すべきであると考えられる。

We reviewed the outcome of vitreous surgery on 40 eyes with vitreous hemorrhage, rheg-matogenous or tractional retinal detachment secondary to branch retinal vein occlusion. Tractional retinal detachment was a major complication when vitreous hemorrhage was left untreated for prolonged period. Iatrogenic retinal break was the sole intraoperative complication, occurring during manipulation of prolifer-ated membrane in 4 eyes of tractional retinal detachment. Postsurgical retinal detachment developed in 4 eyes. It was due to oral dialysis in 3 eyes and to iatrogenic retinal break in one. Following surgery, the visual acuity improved in 34 eyes, 85%. Final visual acuity of 0.5 or over was obtained in 24 eyes, 60%. Improve-ment in visual acuity was limited in eyes with tractional retinal detachment. The findings show that early surgical intervention is indicated for eyes with prolonged vitreous hemorrhage secondary to branch retinal vein occlusion.