HbA1c値の急速な是正に伴い網膜動脈分枝閉塞症を合併した糖尿病網膜症の3症例

Branch retinal artery occlusion in three eyes of diabetic retinopathy following rapid normalization of glycosylated hemoglobin

（展示232）　糖尿病網膜症経過観察中に，ヘモグロビン_A1c （Hb_A1c）値の急速な是正に伴い網膜動脈分枝閉塞症（branch retinal artery occlusion：BRAO）を併発した3症例を経験した。症例1は49歳の男性で，Hb_A1c値がBRAO発症前後2.7か月の間に3.8％（1.4％／月）減少していた。症例2は24歳の妊娠14週の女性で，0.93か月で4.0％（4.3％／月）の減少，症例3は48歳の両眼にBRAOが発症した女性で，4.7か月で6.0％（1.3％／月）の減少が認められた。急速なHb_A1c値の是正がBRAO発症の誘因になった可能性が考えられた。

We observed 3 cases of diabetic retinopathy who developed branch retinal artery occlusion following rapid normalization of hemoglobin A1c. These cases comprised a 49-year-old male, a 24-year-old pregnant female and a 48-year-old female. Branch retinal artery occlusion occurred when hemoglobin A1c was reduced by 3.8% within 2.7 months in the first case, by 4.0% within 0.93 month in the second and by 6.0% within 4.7 months in the third. These findings show that rapid reduction of hemoglobin A1c may trigger branch retinal artery occlusion in diabetic patients.