若年者の虚血型網膜中心静脈閉塞症に対する放射状視神経乳頭切開術の長期経過 (眼科学教室 堀貞夫教授退任記念特別号)  [in Japanese] Long-term Outcome of a Case with Ischemic Type Central Retinal Vein Occlusion Treated by Radial Optic Neurotomy in a Young Adult  [in Japanese]

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Author(s)

    • 山本 香織 Yamamoto Kaori
    • 八戸平和病院眼科;東京女子医科大学医学部眼科学 Dipartment of Ophthalmology, Hachinohe Heiwa Hospital; Department of Ophthalmology, Tokyo Women's Medical University School of Medicine
    • 堀 貞夫 Hori Sadao
    • 東京女子医科大学医学部眼科学 Department of Ophthalmology, Tokyo Women's Medical University School of Medicine

Abstract

緒言:若年者の虚血型の網膜中心静脈閉塞症 (central retinal vein occlusion: CRVO) に対して、放射状視神経乳頭切開術(radial optic neurotomy: RON)を施行し長期経過観察が可能であった症例を報告する。,症例:28歳の男性。初診時右眼の視力は0.2 (矯正不能)で、右眼には全周網膜出血、網膜静脈拡張・蛇行、視神経乳頭浮腫、黄斑部には嚢胞様黄斑浮腫 (cystoid macular edema: CME) ・漿液性網膜剥離を認めた。フルオレセイン蛍光眼底造影では、腕網膜循環時間の遅延(30秒) 、造影早期から網膜血管透過性亢進を高度に認め、網膜周辺に無灌流領域を広範囲に認め、虚血型CRVOと診断した。全身の血液検査で脂質異常症を認めた。RONを施行し、術中術後には重篤な合併症を認めなかった。術後2ヶ月でCMEの再燃を認めたが、トリアムシノロンアセトニドテノン嚢下注射、ベバシズマブ硝子体内注射の施行により改善した。術後3年経過したが、右眼の視力は (0.6) と比較的良好に保たれている。,結論:若年者の虚血型のCRVOに対してRONを施行し、術後3年にわたって良好な視力を維持できた。

Purpose: To report the long-term outcome of ischemic type central retinal vein occlusion in a young adult treated by radial optic neurotomy (RON) .,Case report: A 28-year-old male complained of reduced visual acuity in his right eye . The visual acuity was 0.2 (n.c) at his initial visit. The right eye showed retinal hemorrhage, venous dilation and tortuosity, optic disc edema, cystoid macula edema (CME), and serous retinal detachment (SRD) of the macula. A delay in the arm-to-retina circulation time (30 seconds) was observed in fluorescein angiography, with a high degree of increased retinal vascular permeability along with an extensive nonperfusion area. From these results, the right eye was diagnosed to be ischemic-type CRVO. A general examination revealed hyperlipidemia. The vitrectomy combined with RON was conducted with no adverse side-effects. CME improved but it relapsed at two months after surgery. As a result, the sub-Tenon injection of triamcinolone acetonide and the intravitreal bevacizumab were performed. The long-term outcome at 3 years in the right eye showed a relatively good visual acuity of (0.6).,Conclusion: RON conducted on the ischemic-type CRVO in a young adult resulted in a good visual acuity that was satisfactorily maintained for 3 years.

Journal

  • Journal of Tokyo Women's Medical College

    Journal of Tokyo Women's Medical College 82(-), E273-279, 2012-01

    Tokyo Women's Medical University

Codes

  • NII Article ID (NAID)
    110008767991
  • NII NACSIS-CAT ID (NCID)
    AN00161368
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • Journal Type
    大学紀要
  • ISSN
    0040-9022
  • NDL Article ID
    023518582
  • NDL Call No.
    Z19-400
  • Data Source
    NDL  NII-ELS  IR 
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