糖尿病黄斑浮腫に対する格子状光凝固術の視力転帰

Visual outcome following grid laser photocoagulation for diabetic macular edema

（18-D-17）　び漫性糖尿病黄斑浮腫に対する格子状光凝固術の治療成績を調査し，その有効性について検討した。対象は最近10年間に格子状光凝固を行い12か月以上経過観察した43例51眼で，経過観察期間は平均37.4±28.3か月であつた。格子状光凝固術では，浮腫を消退させ視力を安定化させる効果があったが，最高視力において視力改善した症例は51眼中19眼（37％）で，長期的には徐々に視力低下する傾向がみられた。視力悪化の原因として凝固斑の拡大，網膜色素上皮萎縮などがあった。

We reviewed 51 eyes treated by grid laser photocoagulation for diffuse diabetic macular edema. They were followed up for 12 months or longer, average 37.4±28.3 months (mean±SD) . The macular edema resolved in 86% of eyes and the visual acuity stabilized in 61%. The visual acuity improved temporarily in 37% of eyes and in 16% at the final examination. The visual acuity thus tended to become worse during longer follow-up. Deterioration of visual acuity was statistically significant in eyes with remarkable hard exudates in the macula when compared with those without. There was no significant differences in visual outcome between eyes with cystoid macular edema and without. Severe visual loss was due to enlargement of laser scars and atrophy of the pigment epithelium among others.