前部硝子体線維血管性増殖（Anterior Hyaloidal Fibrovascular Proliferation）

Anterior hyaloidal fibrovascular proliferation

　増殖性糖尿病性網膜症に対する硝子体手術後に，繰り返す硝子体出血と急速な虹彩血管新生及び白内障の進行があり，再手術時に，全網膜の漏斗状剥離をみた2症例を経験した。これは，増殖性糖尿病性網膜症の硝子体手術の合併症として最近報告されている前部硝子体線維性血管増殖（anterior hyaloidal fibrovascular proliferation）であると診断した。この病因として，網膜剥離による著明な網膜虚血状態と硝子体手術後眼における血管新生因子の前眼部移行の促進，新生血管の血液網膜関門の破綻による増殖因子の眼内移行等の関与していることが考えられた。

Two fnmale patients, aged 57 and 60 years esch, underwent vitrectomy for proliferative diabetic retinopathy, followed by recurrent vitreous hemor-rhage, growth of rubeosis iridis and development of cataract. In both cases, additional vitrectomy was performed 6 months later and the retina was in a state of total detachment in a funnel-shaped pat-tern. Newly formed vessels had invaded the ante-rior vitreous originating from the vitreous base. Wediagnosed the cases as anterior hyaloidal fibrovas-cular proliferation (AHFVP).

We presumed three main factors in the path-ogenesis of AHFVP: persistent retinal ischemia after retinal detachment, diffusion of vasoprolifer-ative factors into the anterior ocular segment, and leakage of proliferative factors from the circulat-ing blood into the vitreous cavity due to breakdown of the blood-retinal barrier.