自然閉鎖を認めた黄斑円孔のフーリエドメイン光干渉断層計による閉鎖過程の検討

Spontaneous closure of macular hole followed up by Fourier-domain optical coherence tomography

要約　目的：自然閉鎖した黄斑円孔のフーリエドメイン光干渉断層計による経過の報告。対象と方法：特発性黄斑円孔が自然閉鎖した5例5眼を対象とした。男性2例，女性3例で，年齢は65～78歳（平均73歳）である。結果：フーリエドメイン光干渉断層計による観察で，まず網膜表層に架橋が形成され，次に視細胞の欠損が縮小し，視細胞内外節間の線の連続性が確保されて完全閉鎖に至った。視力改善は，網膜表層の架橋形成時ではなく，視細胞層の欠損が縮小する初期で主に起こった。結論：黄斑円孔が自然閉鎖するときには，網膜表層の架橋形成，視細胞欠損の縮小，内外節間の連続性の回復の過程を経る。

Abstract.　Purpose：To report the course of spontaneous closure of macular hole as observed by Fourier-domain optical coherence tomography. Cases and Method：We observed 5 eyes of 5 patients who showed spontaneous closure of idiopathic macular hole. The series comprised 2 males and 3 females. The age ranged from 65 to 78 years,average 73 years. Results：When observed by Fourier-domain optical coherence tomography,a bridge was initially formed in the inner retinal layer,followed by reduction of defect in photoreceptor layer,and ultimately by established continuity of line between inner and outer segments before closure of macular hole. Visual acuity improved in the initial stage of reduction of defective photoreceptor layer. Conclusion：Spontaneous closure of macular hole proceeds initially by bridge formation in the inner retinal layer,followed by reduction of defect in photoreceptor layer,and finally by continuity of line between inner and outer segments.