続発性黄斑剥離の視力

Visual acuity in secondary detachment of the macula

　過去10年間の非裂孔原性網膜剥離のうち中心性漿液性網脈絡膜症48眼，原田病52眼，脈絡膜血管腫6眼，胞状網膜剥離13眼について，その急性期と寛解期の視力に関係する要素について調べた。視力は矯正視力を用い，対数換算の上平均視力を算出し，有意差検定にはt検定を行った。

　その結果，急性期では，網膜剥離の大きさは視力に関係しなかった。網膜剥離の原因による差が大きく，平均視力は，中心性漿液性網脈絡膜症0.6±0.27，脈絡膜血管腫0.5±0.14，原田病0.4±0.41，胞状網膜剥離0.1±0.53であった。寛解期の平均視力は中心性漿液性網脈絡膜症1.0±0.20，原田病1.0±0.17，脈絡膜血管腫0.9±0.09，胞状網膜剥離0.5±0.56であり，胞状網膜剥離の視力が他の3疾患に比べて有意に不良であった。胞状網膜剥離では網膜剥離の消退後に螢光漏出部から下方に向かう網膜色素上皮の変性を伴いやすく，13眼中8眼にみられた。

　黄斑剥離で視力を規定する要素は単一ではないが，その中でも網膜下液の性質が視力に大きく関係していると結論される。

We evaluated the visual acuity in 119 eyes with secondary detachment of the macula. The series comprised central serous chorioretinopathy 48 eyes, Harada's disease 52, extramacular choroidal an-gioma 6 and bullous retinal detachment 13. We paid particular attention to identify factors which affect the visual acuity during initial and later stages of the diseases.

During the initial stage of the disease, visual acuity averaged 0.6±0.27 in central serous chorio-retinopathy, 0.5±0.14 in choroidal angioma, 0.4±0.41 in Harada's disease and 0.1±0.56 in bullous retinal detachment. The visual acuity was not related to the size of macular detachment. The causative nature of macular detachment was a significant factor.

In the later stage of the disease, the visual acuity averaged 1.0±0.20 in central serous chorio-retinopathy, 0.9±0.09 in choroidal angioma, 1.0±0.17 in Harada's disease and 0.5±0.56 in bullous retinal detachment. Visual acuity in bullous retinal detachment was significantly worse than in the other three disease entities.

It appeared that the nature of subretinal fluid was a major determining factor for visual acuity in secondary macular detachment. Visual acuity was generally poor when the submacular fluid was exudative than serous in nature.