加齢黄斑変性に対する中心窩近傍の脈絡膜新生血管抜去術後の読書評価

Reading ability following surgical removal of juxtafoveal choroidal neovascularization in age-related macular degeneration

　目的：加齢黄斑変性に伴う傍中心窩の脈絡膜新生血管を抜去した後の，視野と読書能力の評価。対象と方法：術後視力が対側眼視力よりもよくなった11眼を対象として，暗点の種類と位置を検索し，縦と横書きの最大読書速度を測定した。結果：絶対暗点が水平方向にある4眼では，縦書きの文章で最大読書速度が平均262字/分であり，上下方向にある4眼では横書きの文章での最大読書速度が平均326字/分であった。暗点が文字に接していない4眼では，縦と横書きに対する最大読書速度に有意差があった。比較暗点のみがある3眼では，どちらの方向でも最大読書速度はほぼ同じであった。結論：絶対暗点の位置と読書能力には関連がある。傍中心窩にある脈絡膜新生血管の抜去手術では，術後の暗点の種類と位置を考慮して方針を決める必要がある。

　Purpose：To evaluate the correlation between visual field and reading ability following surgery for juxtafoveal choroidal neovascularization in age-related macular degeneration. Cases and Method:Eleven eyes of 11 patients entered the study. Their operated eyes had better visual acuity than the fellow eyes. After measurement of the type and location of scotoma,the patients were examined as to the maximal reading speed for horizontal and vertical sentences. Findings：Absolute scotoma was located horizontally in 4 eyes. Their maximum reading speed averaged 262 characters per minute for vertically written sentences. In 4 eyes in which the absolute scotoma was located vertically,the maximum reading speed averaged 262 characters per minute for horizontally written sentences. In 4 eyes in which the scotoma was away from the fovea,there was a significant difference in reading speed for horizontally and vertically written sentences. No such difference was observed in 3 eyes with relative scotoma only. Conclusion：Location of absolute scotoma influences the reading ability. This feature has to be considered in planning surgery for juxtafoveal choroidal neovascularization.