加齢性黄斑変性症網膜下血腫型の視力予後

Visual outcome of age-related macular degeneration with subretinal hematoma

　過去6年間に当科で加齢性黄斑変性症（ARMD）網膜下血腫型と診断された33眼の，視力予後について検討した。血腫が中心窩を含む22眼（中心窩群）と，中心窩を含まない11眼（傍中心窩群）に分け，以下の3項目で有意の差を認めた。1）最終視力0.1以上；中心窩群22眼中4眼，傍中心窩群11眼中9眼（p＜0.0l），2）網膜下血腫の吸収に要した期間：中心窩群27.5週，傍中心窩群16.6週（p＜0.01），3）黄斑下線維性痕痕または円板状病巣：中心窩群（確認できた）20眼中18眼，傍中心窩群11眼中3眼（p＜0.01）。中心窩型のARMD網膜下血腫型は，傍中心窩型に比較して出血の吸収が遅く，線維性瘢痕や円板状病巣が形成されやすく，視力予後は不良であった。

We evaluated the visual outcome of age-related macular degeneration with subretinal hematoma in 33 eyes during the foregoing 6 years. The eyes were divided into two groups: subfoveal hematoma 22 eyes and extrafoveal hematoma 11 eyes. Final visual acuity of 20/200 or more was obtained in 6 eyes in the foveal group and in 9 eyes in the extrafoveal group. The difference was significant (p＜0.01). The duration of subretinal hematoma before disappearance averaged 27.5 weeks in the subfoveal group and 16.5 weeks in the extrafoveal one (p＜0.01). The lesion eventually turned into disciform lesion and/or submacular fibrous scar in 18 of 20 eyes in the subfoveal group and in 3 of 11 eyes in the extrafoveal one (p＜0.01). The findings show that the subfoveal type takes longer before absorption of hematoma, tends to turn into disciform lesion and/or submacular fibrous scar and results in less favorable visual outcome.