網膜細動脈瘤の終末像について

Cicatricial stage of retinal arterial macroaneurysms.

　発症から6か月以上，平均18.2か月を経過し，再出血や滲出性変化の増大がみられなくなった網膜細動脈瘤患者20例の検眼鏡的観察を行った。発症時の平均年齢は71.2歳で，光凝固施行例は4例である。最終観察時に5例は細動脈瘤が検眼鏡的に観察されず，9例は細動脈に隣接して，6例は細動脈下に瘢痕が観察されたが，瘢痕が細動脈上に観察される症例はなかった。瘢痕の大きさや形状はさまざまであるが，その検眼鏡的性状は線維質の9症例と白斑状の6症例とに分類できた。発症部の細動脈は16例で局所的狭窄を，15例で白鞘化を認めたが，細動脈枝閉塞例は認められなかった。

We observed 20 patients with retinal arterial macroaneurysm. Patient ages averaged 71.2 years at the onset of the disease. Four cases were treated with and 16 cases without photocoagulation. The follow-up period ranged from 6 to 47 months (average: 18.2 months) from the onset. No patients developed late haemorrage or recurrentexudation throughout the course of observation.

Fundoscopically, 5 aneurysms (25%) were not detected at the end of follow-up, but in 15 patients scars of the aneurysm remained. The scars lay adjacent (45%) or subjacent (30%) to the arteriole, without an overlying scar. These scars varied in size and shape. Fundoscopic examination of the surface of the scars allowed a grouping into fibrous type (60%) and plaque like type (40%).

Focal narrowing of arteriole was observed at the site of the scar of aneurysms in 16 patients (80%). The arteriole showed sheathing near the scars in 15 patients (75%). Branch retinal arteriole occlusion was not present in the present group.