老人性円板状黄斑変性症に対する光凝固治療成績の生命表による解析

A life table analysis of effect of photocoagulation in senile disciform macula degeneration

　老人性円板状黄斑変性症に対して1986年から，色素レーザーを用いた治療成績を，生命表を用いて分析したので報告する。生命表による判定は視力と眼底所見について行った。1年目と4年目の視力の保持率は，漿液性網膜剥離期では73％と64％と最もよく，ついで網膜下血腫型が60％と60％，網膜下結合織増殖型が62％と54％，網膜下嚢胞型が52％と35％で，全体での4年生存率は，57％であった。特に漿液性網膜剥離期で新生血管の位置が中心窩から200μm以上離れていたものはそれぞれ82％と72％ときわめてよかった。すなわち，本症の早期例のレーザー光凝固例は良好なことが示された。

We evaluated the outcome of 252 eyes with senile disciform macular degeneration treated by dye laser photocoagulation during the past 5-year period. We applied life table analysis to the evalua-tion. We judged eyes as unsuccessful which lost visual acuity by 2 lines or more, or in which the funduscopic features deteriorated including sub-retinal hemorrhage, retinal detachment or sub-retinal firosis. The survival rate of visual acuity at 4 years was 57%. At 1 and 4 years each, the rates were 73% and 64% for serous retinal detachment type, 60% and 60% for subretinal hematoma type, 62% and 54% for subretinal fibrous proliferation type, and 52% and 35% for subretinal cystic type. The survival rates rapidly dicreased during the first 6 months and remained stabilized, particularly for serous retinal detachment and subretinal hematoma types. The therapeutic outcome was more favorable in eyes with choroidal neovascular-ization located 200 μm or more from the fovea. It was poor in eyes belonging to subretinal fibrous proliferation type regardless of the distance of choroidal neovascularization.