強膜短縮黄斑移動術後の回旋複視

Torsional diplopia following macular translocation with scleral shortening

　中心窩の脈絡膜新生血管に対して強膜短縮黄斑移動術を行った15例につき，1か月後の回旋複視を検討した。すべて片眼性であり，原疾患は，加齢黄斑変性6例，ポリープ状網脈絡膜新生血管6例，近視性網脈絡膜変性2例，網膜色素線条症1例である。年齢は39歳から78歳，平均65.2±9.9歳（平均値±標準偏差）である。回旋複視は，70歳以上の高年齢群（p＝0.035），左右眼の視力差が小さい群（p＝0.032），黄斑移動距離が大きい群（p＝0.015），手術眼の固視点での網膜感度が高い群（p＝0.024）で有意に多かった。手術前の視力，利き眼であるかどうか，眼位，両眼視の有無，他覚的回旋偏位は，術後複視と無関係であった。

We reviewed 15 cases treated by macular translocation surgery with scleral shortening regardingtorsional diplopia.All the cases were unilaterally affected including: age-related macular degeneration 6 eyes,polypoid retinochoroidal neovascularization 6 eyes, myopic retinochoroidal neovascularization 2 eyes, and angioidstreaks 1 eye. The ages ranged from 39 to 78 years, average 65.2±9.9 years.At one month after surgery, torsionaldiplopia was significantly more frequent in patients older than 70 yers (p=0.035),lesser difference in visualacuity between both eyes (p=0.032) , larger amount of macular translocation (p=0.015), and higher thresholdof foveal retinal sensitivity in operated eyes (0.024) . Following factors were not related to postoperative diplopia:visual acuity in operated eyes prior to surgery, initial eye position, binocular function, and objective cyclodeviation.