滲出型加齢黄斑変性の自然軽快例の光干渉断層計所見

Optical coherence tomographic findings in spontaneously regressed cases of exudative age-related macular degeneration

　滲出型加齢黄斑変性症と診断され，経過中に脈絡膜新生血管の活動性が自然軽快した6例6眼を光干渉断層計（OCT）で検索した。活動期には病巣からの出血・滲出と，0.5〜2乳頭径大の新生血管があり，Gass分類で2型5眼，1＋2型1眼と判定した。OCT所見からみた新生血管の退縮形式には2つのタイプがあった。1つは2型新生血管に一致する多重高反射が経過中にさらに高い反射に変化して縮小したもの4眼で，他の1つは2型新生血管の感覚網膜側に白色反射を交える高反射層が生じて新生血管が縮小したもの2眼である。滲出型加齢黄斑変性症での新生血管自然退縮の形式として，前者は新生血管板の線維化による退縮，後者は網膜色素上皮の囲い込みによる新生血管の退縮に相当すると解釈した。

We evaluated 6 eyes of 6 patients with exudative age-related macular degeneration that underwent spontaneous regression of choroidai neovascularization (CNV) using an optical coherence tomography (OCT). During the active stage, the eyes had subretinal hemorrhage and exudation from CNVs ranging from 0.5 to 2 disc diameters in size. Five eyes belonged to type 2 and one eye to type 1+2by Gass's classification. There were two types in regression of CNVs. Four eyes initially showed high reflectivity that further increased during the course of regression. The other two eyes developed a highly reflective band between the sensory retina and neovascular membrane during the course of regression. The former type was interpreted as regression by fibrosis of neovascular membrane, and the latter as regression of CNVs by envelopment by the retinal pigment epithelium.