臨床眼科76巻8号

2022年08月発行

連載 国際スタンダードを理解しよう！　近視診療の最前線・23

—近視そのものが失明を起こす—病的近視—近視性牽引黄斑症—硝子体術後の黄斑部萎縮

著者： 方雨新¹ 大野京子¹

所属機関： ¹東京医科歯科大学大学院医歯学総合研究科眼科学分野

ページ範囲：P.1038 - P.1044

◆東京医科歯科大学のデータによると，近視性牽引黄斑症または黄斑円孔網膜剝離（MHRD）を有する強度近視眼のうち，11％が経毛様体扁平部硝子体切除術（PPV）および内境界膜（ILM）剝離術後に黄斑萎縮（MA）を発症することを示した。PPV後のMA発症率は，黄斑網膜分離症を有する眼で3.3％，中心窩網膜剝離を有する眼で4.4％，全層黄斑円孔を有する眼で13.2％，MHRDを有する眼で30％であった。そのため，術前にMHRDを有することはMA発症の危険因子となる。

◆手術手技，インドシアニングリーンの毒性と網膜色素上皮の固有の感受性は，MAの発症に寄与する主な要因と見なされるべきである。

◆MAは，病的近視患者におけるPPV後の合併症に含まれる必要がある。

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