臨床眼科70巻13号

2016年12月発行

特集 脈絡膜から考える網膜疾患

糖尿病と脈絡膜

著者： 村上智昭¹

所属機関： ¹京都大学大学院医学研究科眼科学

ページ範囲：P.1868 - P.1873

はじめに

　糖尿病網膜症（diabetic retinopathy：DR）は糖尿病細小血管障害の1つであり，網膜血管障害に伴う神経グリアの機能低下が視機能障害を惹起する^1）。しかし，網膜外層は主に脈絡膜からの栄養を受けており，眼内液の流れの方向が硝子体から脈絡膜であることから，脈絡膜の灌流がDRの病態に影響を及ぼしている可能性が高い^2）。Spectral-domain optical coherence tomography（SD-OCT）を用いたenhanced depth imaging（EDI）法やswept source（SS）-OCTによる脈絡膜の画像解析が臨床導入され，DRの病態および介入の影響との関連が多数報告されている。相反する結果もしばしばみられ確固たる位置づけがなされていないが，DR眼における脈絡膜の病態理解の現在地をまとめてみたい。

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