未熟児網膜症の光凝固・冷凍凝固治療による視機能への影響

Visual outcome of retinopathy of prematurity after treatment by photocoagulation or cryopexy

　未熟児網膜症の瘢痕病変が比較的軽度で同程度の，治療15例30眼，自然治癒15例29眼を対象として，瘢痕期の視機能を比較した。矯正視力は，治療眼，自然治癒眼とも9割が0.7以上であった。屈折値は，治療眼の7割，自然治癒眼の9割が，＋3Dから−3Dの範囲に含まれたが，全周光凝固施行例1例で，強度の近視性乱視を認めた。眼位異常は治療例より自然治癒例に多かった。治療の有無と眼軸長に明らかな相関はなかった。

　光凝固治療はそれ自体視機能への影響は小さく，結果的に瘢痕を軽度にしてよりよい視機能を得るために，症例によっては活動期Ⅲ期中期の増殖性病変に部分的な適応を考慮するなど，これまで以上に積極的に選択されてよいと考えた。

We reviewed a series of 59 eyes with retinopathy of prematurity regarding visual acuity, refractive error, eye position and axial length. The retinopa-thy had regressed spontaneously in 29 eyes and the other 30 eyes had to be treated with photocoagula-tion or cryopexy during the active stage of the disease. All the cases were aged from 6 to 14 years at the time of present investigation.

Corrected visual acuity was 0.7 or more in 90% of eyes in treated and nontreated groups. Refractive error was moderate in both groups. Incidence of strabismus was the same in both groups. The degree of myopia was not correlated with the axial length. The findings seemed to suggest that photocoagulation or cryopexy did not adversely affect the visual functions when applied during the active stage of retinopathy of prematurity.