加齢黄斑変性に対する放射線治療の長期経過

Longterm effects of radiation treatment for age-related macular degeneration

（18-D-16）　加齢黄斑変性の中心窩下脈絡膜新生血管に対する放射線治療の長期経過（10Gy30か月，20Gy24か月）を報告する。6か月以内に悪化傾向のみられた60歳以上の症例で，螢光造影で証日月された中心窩にかかる新生血管板に対し，10Gy （2Gy×5日間），20Gy （2Gy×10日間）を各々15眼に照射し1同条件をみたす無治療症例16眼とretrospectiveに比較した。血管板の変化は無治療群よりも治療群で良好な傾向がみられた。最終視力が0.1を超える率は10Gyで20％，20Gyで53％，対照群で0％と，治療群で有意に高く（p＜0.01），視力の悪化をvisual angleの2倍以上の変化とするとき，20Gy群で視力不変以上の率が47％と，対照群の13％に比べて有意に高かった（p＜0.01）。

We reviewed the longterm effect of radiation on age-related macular degeneration in 30 eyes. All the patients were aged 60 years or over. As the criteria for entering the study, all eyes had to show tendency for exacerbation during the past 6 months and the presence of choroidal neovascularization had to be verified by fluorescein angiography. One group of 15 eyes received a total of 10 Gy divided in 5 fractions. The other group of 15 eyes received a total of 20 Gy divided in 10 fractions.Another group of untreated 16 eyes with similar lesions were restrospectively assessed. The irradiated eyes showed beneficial tendencies as compared with the untreated. Final visual acuity of 20/200 was attained in 20% of eyes receiving 10 Gy, 53% of eyes receiving 20 Gy and in no eye which did not receive radiation. The difference was significant (p ＜ 0.01). When deterioration of visual acuity is defined as twice of the visual angle, stability or improvement in visual acuity was attained in 47% of eyes treated by 20 Gy and in 13% of untreated eyes. The difference was significant (p ＜ 0.01) .