網膜静脈分枝閉塞症に対する硝子体手術後の網膜虚血の経時的変化

Changing patterns of retinal ischemia following vitrectomy for branch retinal vein occlusion

　網膜静脈分枝閉塞症続発黄斑浮腫に対して硝子体手術を施行し，1年以上経過観察した11例11眼について，蛍光眼底造影にてびまん性黄斑浮腫，嚢胞様黄斑浮腫，中心窩周囲毛細血管網の障害，周辺部無血管野の術前・術後の状態および術前・術後の視野の比較検討を行った。術後1年以上経過した症例では黄斑浮腫は全例で改善した。術前に中心窩周囲毛細血管網の閉塞を認めた9眼のうち8眼は術後に閉塞が消失し，周辺部無血管野は術後に9眼中8眼で消失した。また，術前・術後に視野検査を行った7眼のうち，3眼で改善，3眼で悪化を認めた。硝子体手術を行った症例では網膜虚血の改善それに伴う視野の改善が得られる可能性が示唆された。

We reviewed 11 eyes of branch retinal vein occlusion treated by vitrectomy. They were followed up for oneyear or longer. We paid particular attention to diffuse or cystoid macular edema, perifoveal capillary network and avascular area in the peripheral fundus as observed by fluorescein angiography before and after surgery. At one year after surgery,all the eyes showed improvement in macular edema. Drop-out of perifoveal capillaries were present in 9 eyes beforesurgery. It disappeared due to reperfusion in 8 eyes after surgery. Avascular area in the periphery was present in 9 eyesbefore surgery and disappeared in 8 eyes after surgery. Perimetry was performed in 7 eyes, of which the visual fieldimproved in 3 eyes, remained unchanged in 1 eye, and deteriorated in 3 eyes. The findings show that vitrectomy mayimprove retinal ischemia and visual field defects in eyes with branch retinal vein occlusion with macular edema.