大量の網膜下血腫，硝子体出血を来した老人性円板状黄斑変性症

Senile disciform macular degeneration associated with massive subretinal or vitreous hemorrhage

　大量の網膜下血腫，硝子体出血を来した老人性円板状黄斑変性症10例，10眼について報告した．平均年齢は61歳で，40歳台にも2例見られた．中心暗点や変視症で発症し，1週から数週間後に大量の網膜下血腫，硝子体出血を来し，視力障害が高度となった．他眼に老人性円板状黄斑変性症を認めたものが3眼，黄斑部に多数のドルーゼンを認めたものが2眼あった．硝子体手術施行の6眼中3眼は，視力の改善が見られたが，他の3眼は黄斑部網膜の変性が高度であったため視力は回復しなかった．

　高齢者の硝子体出血の原因の一つとして，老人性円板状黄斑変性症を常に考慮すべきである．

We observed 10 cases of senile disciform macular degeneration (SDMD) with either large subretinal hematoma (3 eyes) or massive vitreous hemorrhage (7 eyes) during the foregoing 12-month period. The ages varied from 44 to 86 years, average 61 years. The occurrence of massive subretinal or vitreous hemorr-hage was generally very rapid, as it occurred within 2 to 3 weeks after central scotoma or metamorphopsia as initial symptoms. The fellow eye was uneventful in 5 eyes : SDMD was present in 3 eyes and drusen in 2.

Six eyes with massive vitreous hemorrhage was treat-ed by pars plana vitrectomy 3 to 6 months later.Massive scatterred subretinal hematoma was the com-mon postsurgical finding. The postsurgical visual acuity was variable as it depended on the state of macular damage.

SDMD is to be taken into consideration as a possible cause of vitreous hemorrhage in elder subjects.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(9) : 1043-1046, 1986