糖尿病黄斑症のタイプ分類と硝子体手術成績

Outcome of vitrectomy in different types of diabetic maculopathy

　糖尿病黄斑症を型別に分類し，硝子体手術の適応と判断された56眼について治療法と手術成績を検討した。びまん性黄斑浮腫（M1型）では後部硝子体剥離の作成を基本とし，浮腫が高度なものは内境界膜剥離や嚢胞様黄斑浮腫穿刺を併用した。M1型45眼では29眼（64％）で2段階以上の視力改善を得た。網膜下に硬性白斑のあるM2型とM3型では，後部硝子体剥離に加え，網膜下の白斑を除去した。M2型7眼では全例が2段階以上に視力が改善した。M3型4眼では早期手術例を除き，視力予後は概して不良であった。

We reviewed the outcome of vitrectomy in 56 eyes of diabetic maculopathy after classifying them into three types. Eyes with diffuse macular edema (type Ml) received posterior vitreous detachment. Eyes with severe macular edema received, additionally, peeling of internal limiting membrane or macular cystotomy. In 45 eyes belonging to type Ml, visual acuity improved by 2 lines or more in 29 eyes (64%). In eyes with subretinal hard exudates (type M2 and M3) received removal of exudates in addition to posterior vitreous detachment. In 7 eyes belonging to type M2, visual acuity improved by 2 lines or more in all the eyes. In 4 eyes belonging to type M3, visual acuity was poor except in early operated cases.