硝子体出血をきたした広範な網膜下出血の検討

Cases of vitreous hemorrhage secondary to massive subretinal hemorrhage

（B9-1-15）　硝子体出血に対し硝子体手術を施行し，5乳頭面積以上の網膜下出血のみられた12例12眼（男性9例，女性3例，平均年齢67歳）の臨床的特徴を検討した。原疾患は加齢黄斑変性症（AMD）が6例，網膜細動脈瘤が1例，原因不明例が5例だった。術前視力は12例中11例が手動弁以下で，最終視力は光覚なし〜0.8だった。AMDに比べ原因不明例は，若年で視力予後良好だった（p＜0.05）。また片眼性で性差がなく，急性ないし亜急性の経過を示し黄斑部病変が軽度という特徴があり，AMDとは異なった疾患が原因である可能性が高いと考えられた。

We reviewed 12 eyes of 12 patients which were surgically treated for vitreous hemorrhage secondary to massive subretinal hemorrhage. Subretinal hemorrhage was eventually caused by age-related macular degeneration in 6 eyes, retinal macroaneurysm in one eye and idiopathic in 5 eyes. Visual acuity prior to surgery was 0.09 in one eye and hand motion or worse in 11 eyes. It improved to maximally 0.8 after surgery and was hand motion or werse in 4 eyes. The idiopathic cases tended to be younger and to result in better visual outcome than those secondary to age-related macular degeneration (p＜ 0.05) . The former were characterized by unilateral occurrence, acute or subacute clinical course and minimal macular involvement in both sexes. They appeared to have been caused by choroidal vascular disorders other than age related macular degeneration.