網膜静脈分枝閉塞症における光凝固の嚢胞状黄斑浮腫に対する影響

Effect of photocoagulation for cystoid macular edema in branch retinal vein occlusion

　嚢胞状黄斑浮腫（cystoid macular edema：CME）を合併した網膜静脈分枝閉塞症（branch retinal　vein occlusion：BRVO）24例24眼をscatter光凝固早期（6か月以内）施行群（14例／4眼），光凝固非施行群（10例10眼）に分け，光凝固の有無とCME持続期間，および視力予後について比較検討した。CME持続期間は光疑固施行群で平均23.75±4.54か月，光凝固非施行群で11.30±4.54か月であり，CMEはscatter光凝固施行群において有意に遷延し（p＝0.0443），光凝固スポット数が多い症例ほど持続期間が長い傾向にあった。CME消失後のlogMAR視力は光凝固施行群で平均3.57±4.65，光凝固非施行群で1.72±2.63であり，2群間に有意な差は認められなかった（p＝0.27）。Scatter光凝固はBRVOの合併症予防に有効な治療法であるが，その早期施行はCMEを遷延させる可能性が示唆された。

We reviewed 24 eyes of branch retinal vein occlusion (BRVO) with cystoid macular edema (CME) . The series comprised 14 eyes which received scatter photocoagulation within 6 months of onset and 10 eyes whch did not.The CME persisted for an average of 23.75±4.54 months in the former group and 11.30±4.54 months in the latter.CME thus lasted longer after scatter photocoagulation than the rest (p = 0.0443) and particularly in eyes which received larger number of coagulation spots.The 1og MAR visusal acuity after resolution of CME averaged 3.57±4.65 in photocoagulated eyes and 1.72±2.63 in the others. There was no difference between the two groups (p=0.27). The findings show that scatter photocoagulation may be effective in preventing late complications of BRVO but that it may induce persistent CME when performed early.