硝子体手術を実施した特発性黄斑円孔の固視点

Point of fixation in idiopathic macular holes before and after vitreous surgery

　硝子体手術を実施した特発性黄斑円孔3例4眼に対して，手術前日および手術の3か月後に走査レーザー検眼鏡のスコトメトリーにより，円孔およびその周辺の感度を測定して，同時に固視点を記録した。全例で円孔は閉鎖され視力は改善した。固視点は手術前では，4眼すべてfluid cuff上に存在し，手術後では，4眼すべて中心窩方向へ移動し，4眼中3眼で閉鎖された円孔内に認めた。視力の改善は，単にfluid cuffの機能改善だけでなく，円孔の閉鎖に伴い視細胞層が中心窩方向へ移動して，視細胞の密度が上昇することも関与していると考えられた。

We treated four eyes of idiopathic full-thickness macular hole by vitreous surgery. Anatomic success was achieved with visual improvement in all the eyes. We studied the point of fixation before and 3 months after surgery by means of scotometry using a scanning laser ophthalmoscope. Before surgery, the point of fixation was positioned on the neurosensory detachment at the margin of holes in all the eyes. After surgery, the point of fixation was located within the former holes in 3 eyes. Visual improvement after macular hole surgery appeared to be related to movement of photoreceptor cells as well as reattachment of the cuff of detached retina around the hole.