偽黄斑円孔の網膜断層像

Optical coherence tomographic features of pseudohole of the macula

　偽黄斑円孔眼18例19眼の網膜断層像を光干渉断層計（OCT）で検索し，偽円孔の形態と自覚症状，視力との関係を検討した。偽円孔はOCTの水平断，垂直断で走査し，以下の4型に分類された。Ⅰ型：円筒型＋円筒型（9眼），Ⅱ型：円筒型＋一端がひさし状（4眼），Ⅲ型：巾着型＋一端がひさし状（3眼），Ⅳ型：巾着型＋巾着型（3眼）。変視症の自覚はⅠ型：1／9眼，Ⅱ型：0／4眼，Ⅲ型：2／3眼，Ⅳ型：3／3眼で，巾着型の陥凹を示す型は変視症の頻度が高かった。各型での平均視力で有意な差はみられなかった。19眼中7眼で硝子体手術を施行した。変視症を自覚した4眼中3眼（75％）で変視症が改善した。また7眼中3眼（43％）で2段階以上の視力向上があった。

We evaluated the pseudohole of the macula in 19 eyes using an optical coherence tomography (OCT). Par-ticular attention was paid to the relation between the foveal configuration and visual disturbances including metamor-phopsia and visual acuity. We could identify four types of pseudohole based on horizontal and vertical sections. Nine eyes (type 1) showed a cylinder shape in both sections. Four eyes (type 2) showed a cylinder shape in one section and an inward shelf at the superior margin. Three eyes (type 3) showed a triangular shape in one side and an inward shelf in another. Three eyes (type 4) showed a triangular shape in both sections. Metamorphopsia was present in one eye (11%) in type 1, in none in type 2, in 2 eyes in type 3 (67%), and in 3 eyes (100%) in type 4. There was no difference in visual acuity among the four types. Vitrectomy was performed in 7 eyes with metamorphopsia and/or im-paired visual acuity. After surgery, metamorphopsia decreased in 3 of 4 eyes (75%). Visual acuity improved by 2 lines or more in 3 of 7 eyes (43%).