網膜剥離術後の脈絡膜血流量の変化

Choroidal blood flow following retinal detachment surgery

　黄斑を境界とする裂孔原性網膜剥離が復位した18眼で，脈絡膜循環を検索した。網膜剥離発症から復位までの推定期間は平均45日，復位から脈絡膜循環の検索までの期間は平均3か月であった。レーザースペックル法を用い，網膜剥離復位部と非剥離部の脈絡膜血流をsquare blur rate （SBR）を視標として定量的に測定した。10眼ではインドシアニングリーン蛍光造影（IA）で，脈絡膜循環を定性的に検索した。IAでは網膜剥離境界部の両側で差がなかったが，レーザースペックル法では18眼中17眼でSBR値が網膜剥離復位部で有意に減少し，さらに剥離部と非剥離部を含む黄斑部での血流量が他眼のそれよりも有意に減少していた。陳旧性の網膜剥離復位眼では，剥離があった部位の脈絡膜血流量が減少することを示す所見である。

Purpose: To evaluate the choroidal circulation in 18 eyes after successful surgery for rhegmatogenous retinal detachment.

Cases and Methods: All the 18 eyes had retinal detachment with a borderline through the macula. The duration of retinal detachment until surgery averaged 45 days. The interval between reattachment and measurement of choroidal circulation averaged 3 months. Choroidal circulation in the formerly detached and attached fundus area was quantitated by laser speckle flowgraphy using the square blur rate (SBR) as parameter. Indocyanine green angiography (IA) was performed in 10 eyes.

Results: IA showed no difference in choroidal circulation between the formerly detached and attached fundus area. Laser speckle flowgraphy showed decreased choroidal blood flow in the formerly detached fundus area in 17 of 18 eyes. It also showed significantly decreased flow in the macular area as compared with that in the fellow eyes.

Conclusion: The choroidal circulation is decreased after successful surgery for rhegmatogenous retinal detachment.