◎The degree and condition vary. Bleeding in some part of the fundus (column "What is the fundus") is called retinal hemorrhage. Although it is generally referred to as retinal hemorrhage, the severity and condition of the hemorrhage can vary, and depending on the amount and location of the bleeding and the underlying disease, it can range from something that can be monitored to something that requires emergency surgery. There are many diseases that can cause retinal hemorrhage. Therefore, the treatment varies depending on the underlying disease. Diseases that can cause this include diabetic retinopathy ("diabetic retinopathy"), hypertensive fundus ("hypertensive fundus (hypertensive retinopathy)"), and central retinal vein occlusion ("central retinal vein occlusion"). Age-related macular degeneration (‘Age-related macular degeneration’) or eye trauma (‘Eye trauma’) may also be the cause. Rhegmatogenous vitreous hemorrhage is a condition in which retinal blood vessels break and bleed along with posterior vitreous detachment, which is seen in elderly people, causing bleeding in the retina. Since it can cause retinal detachment, emergency surgery is often required. Retinal microaneurysms are also a common cause of the condition. These are caused by a bulge in the retinal artery of elderly people, and when the bulge ruptures, it causes bleeding in the retina. Laser photocoagulation therapy can be used to treat this condition. Coats' disease is a unilateral (occurring in one eye) disease that occurs in young men or children, and is caused by congenital abnormal retinal vascular bleeding and retinal detachment. It is treated with laser photocoagulation therapy and cryotherapy. Uveitis, which occurs as one of the symptoms of systemic lupus erythematosus, Behçet's disease, sarcoidosis, etc., can also cause retinal vasculitis and lead to retinal hemorrhage. Drugs that suppress inflammation are used to treat these conditions. Eales' disease is a condition in which repeated bleeding occurs due to blocked retinal blood vessels. This can also cause retinal hemorrhage. It is treated with laser photocoagulation therapy or surgery. In addition to these, retinal hemorrhage can occur due to various other causes, such as blood disorders. Source: Shogakukan Home Medical Library Information |
◎程度、状態はさまざま 眼底(コラム「眼底とは」)のどこかの部位が出血した状態を、眼底出血といいます。 ひとくちに眼底出血といっても、その程度や状態はさまざまで、出血の量や場所、原因疾患によって、ようすをみてよいものから緊急手術が必要なものまであります。 ◎眼底出血をおこす病気 眼底出血をもたらす病気はたくさんあります。したがって、その原因となる病気によって治療法も異なります。 原因となる病気には、糖尿病網膜症(とうにょうびょうもうまくしょう)(「糖尿病網膜症」)、高血圧性眼底(「高血圧性眼底(高血圧性網膜症)」)、網膜中心静脈閉塞症(もうまくちゅうしんじょうみゃくへいそくしょう)(「網膜中心静脈閉塞症」)などがあげられます。 加齢性黄斑変性症(かれいせいおうはんへんせいしょう)(「加齢黄斑変性(加齢性黄斑変性症)」)や目の外傷(「目の外傷」)が原因になることもあります。 裂孔原性硝子体出血(れっこうげんせいしょうしたいしゅっけつ)は、高齢者にみられる後部硝子体剥離(こうぶしょうしたいはくり)にともなって網膜血管が切れて出血するもので、眼底出血をもたらします。網膜剥離をおこすことがあるため、しばしば緊急手術が必要となります。 網膜細動脈瘤(もうまくさいどうみゃくりゅう)もよくみられる原因疾患です。これは高齢者の網膜動脈に瘤(こぶ)ができるもので、瘤が破れると眼底出血が生じます。レーザー光凝固療法(ひかりぎょうこりょうほう)で対応することがあります。 コーツ病は、若年男子、あるいは子どもにおこる片眼性(へんがんせい)(どちらか片方の目におこる)の病気で、先天性の異常網膜血管部位から出血したり、網膜剥離をおこしたりします。レーザー光凝固療法や冷凍凝固療法などで治療されます。 全身性エリテマトーデス、ベーチェット病、サルコイドーシスなどの症状の1つとしておこるぶどう膜炎(「ぶどう膜炎」)も網膜血管炎をおこし、眼底出血をもたらすことがあります。これらの治療には炎症をしずめる薬が使用されます。 イールズ病は、つまった網膜血管がもとで出血をくり返す病気です。これも眼底出血の原因になります。レーザー光凝固療法や手術で治療されます。 これらのほかにも、血液疾患などさまざまな原因によって眼底出血がおこることがあります。 出典 小学館家庭医学館について 情報 |
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