光干渉断層計による黄斑前膜の分類

Classification of epiretinal membranes based on findings by optical coherence tomography

　網膜硝子体界面を主座とする疾患である網膜前膜127眼を光干渉断層計で検索した。これには硝子体黄斑牽引症候群16眼が含まれる。網膜前膜と網膜の癒着様式には，面癒着型89眼と架橋型38眼があった。架橋型では中心窩の生理的陥凹が全例で消失していたが，面癒着型では陥凹は必ずしも消失せす，偽円孔を呈するものがあった。硝子体黄斑牽引症候群はすべて架橋型であり，接線方向の牽引索が明瞭に検出された。以上から，網膜前膜は，1）面癒着型で中心窩陥凹が存在（24眼），2）面癒着型で中心窩陥凹が消失（39眼），3）面癒着型で偽黄斑円孔（26眼），4）架橋型（38眼）の4型に分類された。

We examined consecutive 127 eyes with epiretinal membrane using an optical coherence tomography (OCT). The series included 16 eyes of vitreomacular traction syndrome. Epiretinal membranes showed two types re-garding the mode of adhesion to the retinal surface. They were adherent to the retina totally in 89 eyes and partially forming a bridge in 38 eyes. The physiological foveal pit was absent in all the eyes with partial adhesion to the retina in-cluding those with vitreomacular traction syndrome. It was often present in eyes with total adhesion. Pseudohole of the macula was present only in eyes with total adhesion. Epiretinal membrane was thus classified into 4 types: total adhesion with patent foveal pit 24 eyes, total adhesion with absent foveal pit 39 eyes, total adhesion with macular pseu-dohole 26 eyes, and partial adhesion 38 eyes.