内境界膜剥離後の眼底に認める網膜神経線維層欠損様変化

Findings simulating retinal nerve fiber layer defect following peeling of internal limiting membrane

　内境界膜剥離を併用して硝子体手術を行った107眼中の30眼（28％）に，網膜神経線維層欠損様所見を術後に認めた。内訳は，黄斑上膜12眼中8眼（67％），黄斑円孔36眼中18眼（50％），黄斑浮腫（糖尿病網膜症，網膜静脈閉塞症）59眼中4眼（7％）である。術中のICG使用の有無は，これの出現頻度に影響しなかった。経過観察中にこの変化の消失ないし改善はない。黄斑円孔と黄斑上膜での視力と網膜感度には，これの有無による有意差はなかった。内境界膜剥離による網膜神経線維層欠損様所見が視機能に影響する可能性があるので，症例ごとの長期観察が必要である。

Findings simulating retinal nerve fiber layer defect (NFLD) developed in 30 out 107 eyes (28%) following peeling of internal limiting membrane (ILM). This finding was observed in 8 out of 12 eyes with idio-pathic epiretinal membrane, 18 out of 36 eyes with idiopathic macular hole, and 4 out of 59 eyes with macular edema secondary to diabetic retinopathy or retinal vein occlusion. The incidence of this finding was independ-ent of the adjunct use of indocyanine green (ICG) daring surgery. There has been no inprovement or disap-pearance in this finding during the course of observation. In eyes with idiopathic epiretinal membrance or me-cular hole, the presence of this finding old not significantly affect the sivual acuity or retinal sensitivity.Longterm follow-up is advocated in these cases for eventual damage to the visual function secondary to ILM peeling.