クリプトンレーザーによる中心性漿液性脈絡網膜症の光凝固療法の成績

Krypton laser photocoagulation in central serous chorioretinopathy

　Coherent社クリプトンレーザー光凝固装置（システム910）を用いてこの1年間に中心性漿液性脈絡網膜症（中心性網膜炎）64例65眼に光凝固を行った．合併症を防止して治療効果をあげるために，大きいスポットサイズ（200μm），長い凝固時間（0.2秒）を凝固の標準とし，平均85mWの低出力で螢光漏出点を含めその周囲に数発の凝固を加えた．網膜剥離完全消失までの期間は平均2.9週で，術後視力の回復も良好であった．光凝固部の瘢痕は軽く，そこに一致する暗点は小さいかあるいは証明されず，また合併症は見られなかった．クリプトンレーザー光を用いると，中心窩の近くの凝固も可能で，中心性網膜炎に対する光凝固にはアルゴンレーザー光よりもクリプトンレーザー光の方が有利であった．

We treated 65 eyes of 61 patients with typical central serous chorioretinopathy by means of red krypton laser. Laser beam was applied directly to the site of leakage of fluorescein and the surrounding areas. We normally used a relatively large spot size (200μm), low intensity (85mW) and longer dura-tion (200msec).

Typically, the visual acuity began to improve week after photocoagulation. The serous detachment in the macula disappeared after an average of 2.9 weeks. Full visual acuity was attained after onemonth.

When compared with argon, red krypton laser resulted in less damage to the sensory retina and in smaller objective scotoma that could be recorded in 17 eyes (55%).

Because of this feature, there was no patient who noticed subjective scotoma. From these findings, we think that the krypton laseris superior to argon in the treatment of central serous chorioretinopathy, particularly in cases with leakage points located in the perifoveal area.