加齢黄斑変性に対する光凝固治療

Outcome of photocoagulation for age-related macular degeneration

（P−2-99）　脈絡膜新生血管が中心窩外にある加齢黄斑変性への光凝固の効果を，1997年までの5年間の自検例66例66眼について検討した。波長595nmのレーザー光凝固後，6か月以上経過が追えたものとした。視力は，改善が14眼（21％），不変29眼（44％），悪化23眼（35％）であった。脈絡膜新生血管の大きさが1乳頭面積以内の症例で有意に良好な視力が得られ，網膜色素上皮剥離と網膜下増殖組織がある症例で視力の転帰が不良な傾向があった。中心窩と新生血管の距離が500μm以上の症例で視力改善率が良い傾向があった。視力低下の自覚から光凝固までの期間，治療後の期間，光凝固実施時の視力，年齢は，視力の転帰とは無関係であった。

We reviewed the result of photocoagulation in 66 eyes of 66 cases of age-related macular degeneration during 5 years through 1997. All the cases were followed up for 6 months or longer after dye laser photocoagulation at the wavelength of 595nm. The visual acuity improved in 14 eyes (21%) , remained unchanged in 29 eyes (44%) and deteriorated in 23 eyes (35%). Final visual acuity was significantly better when the choroidal neovascularization was smaller than one disc area. It was unfavorable when associated with detachment of retinal pigment epithelium or subretinal proliferation. It tended to be better when the distance between the fovea and the neovascularization was greater than 500 gm. The outcome was independent of age, visual acuity at the time of treatment, duration after photocoagulation, or interval between onset of visual impairment and treatment.