加齢黄斑変性症に対する光凝固と硝子体手術の成績

Results of photocoagulation and vitreous surgery for age-related macular degeneration

（25E-24）　中心窩脈絡膜新生血管膜（choroidal neovascular membrane：CNM）を有する加齢黄斑変性症に対する光凝固と硝子体手術の視機能を比較検討した。対象は光凝固群が54例54眼、手術群が16例16眼で，それぞれの症例において術前と術後6か月の視力，中心視野で眼底所見を比較した。視力，中心視野ともに両群間に有意差はみられず，手術は光凝固療法と同様に有効と思われた。手術群の有用性は，出血・網膜剥離の吸収までの期間が光凝固群より早く，再発もみられなかったことであったが，問題点は，CNMの摘出時に同時に網膜色素上皮や脈絡毛細管板の除去が必発で術後その部が暗点となることであり，手術の適応については今後さらに検討が必要であると思われた。

We reviewed the therapeutic outcome in 70 eyes of age-related macular degeneration. Dye laser photocoagula-tion was performed in 54 eyes and removal of submacular neovascular membrane by vitreous surgery in 16 eyes. When evaluated 6 months after treatment, there was no significant difference between the two groups regarding the visual acuity and central visual field. This finding shows that vitreous surgery is equally effective as photocoagulation. Vitreous surgery induced earlier resolution of submacular hemorrhage and macular detachment than photocoagulation. There was no recurrence after vitreous surgery. Postsurgical scotoma was unavoidable due to removal of choroidal neovascular tissue, retinal pigment epithelium and the choriocapillaris. Indication of vitreous surgery is to be decided with these features inmind.