網膜静脈分枝閉塞症における硝子体手術の長期効果

Long-term outcome of vitrectomy for branch retinal vein occlusion

要約　目的：網膜静脈分枝閉塞症に伴う黄斑浮腫に対し，早期または発症から3か月経過観察した後に硝子体手術を行った長期効果の検討。対象と方法：網膜静脈分枝閉塞症に伴う黄斑浮腫を認め，術前視力0.5以下，浮腫改善目的で硝子体手術を行った52例52眼を対象とした。発症から手術までの期間が120日以内の群を早期群（27眼），120日を超えた群を後期群（25眼）と2群に分け，術前後の矯正視力および中心窩網膜厚を測定し比較検討した。結果：視力経過では，早期群と後期群とも，術前と比較し術後12～24か月で有意な改善を認めた。網膜厚の経過では，2群とも術前と比較し術後6～24か月で有意な減少を認めた。術後視力および術後網膜厚の推移については2群間に差はなかった。結論：網膜静脈分枝閉塞症に伴う黄斑浮腫に対する硝子体手術は，発症からの経過時間による効果の差はなかった。

Abstract.　Purpose：To evalute the long-term outcome of early and late vitrectomy for macular edema associated with branch retinal vein occlusion（BRVO）. Cases and Method：Fifty-two eyes in 52 patients who exhibited macular edema associated with BRVO,had preoperative visual acuity of 0.5 or lower,and performed vitrectomy for to improve macular edema were included in the study. Twenty-seven eyes that received vitrectomy within 120 days of onset were defined as early-surgery group and 25 eyes that received vitrectomy exceeding 120 days from onset were defined as late-surgery group,and visual acuity and central retinal thickness were compared at baseline and after surgery. Results：Visual acuity improved significantly after 12 to 24 months after surgery compared to baseline in both groups. Central retinal thickness decreased significantly after 6 to 24 months after surgery compared to baseline in both groups. There was no difference between the two groups in the time-course of visual acuity or retinal thickness. Conclusion：The outcome of vitrectomy performed for BRVO did not depend on the duration from onset of BRVO.