網膜下血腫によって漏斗状網膜剥離に至った加齢黄斑変性の手術経験

Results of surgery for funnel-shaped hemorrhagic retinal detachment secondary to age-related macular degeneration

　急速に網膜下血腫が増大し漏斗状の出血性網膜剥離（以下，漏斗状網膜下血腫）に至った加齢黄斑変性の4症例を経験した。全例，硝子体出血のために眼底が透見不能で，MRIによって漏斗状網膜下血腫が確認された。硝子体手術を行い網膜下血腫の除去を可能な限り行ったが完全に除去することはできなかった。視力は術前が無光覚2眼，光覚2眼で，術後が無光覚1眼，光覚1眼，手動弁1眼，0.02が1眼であった。漏斗状網膜下血腫眼では，手術による視力改善はわずかであり，手術適応は慎重に考慮すべきである。また，加齢黄斑変性で眼底が透見不能な場合は，手術の直前にMRI等による画像診断を行って網膜の状態を確認する必要がある。

We treated four eyes with funnel-shaped hemorrhagic retinal detachment secondary to age-related macular degeneration. In all the eyes, the fundus could not be observed due to massive vitreous hemorrhage. Magnetic resonance imaging, MRI, showed the presence of retinal detachment with subretinal hemorrhage. Removal of blood mass posterior to the detached retina was attempted by vitreous surgery with partial success. The preoperative visual acuity was light perception 2 eyes and no light perception 2 eyes. The postoperative visual acuity was 0.02 1 eye, hand motion 1, light perception 1 and no light perception 1. Improvement in visual function was generally poor, suggesting that an utmost caution is necessary in advocating surgery for funnel-shaped hemorrhagic retinal detachment. Further, diagnosis by MRI imaging is necessary in planning surgery in eyes with opaque media and age-related macular degeneration.