網膜血管腫状増殖に対するbevacizumab併用光線力学的療法の治療効果

Outcome of retinal angiomatous proliferation after combined treatment with photodynamic therapy and intravitreal bevacizumab

要約　目的：網膜血管腫状増殖（retinal angiomatous proliferation）に対する光線力学的治療とbevacizumab硝子体内投与の併用療法の効果の報告。症例と経過：男2例と女1例の3例3眼を対象とした。年齢はそれぞれ68，69，90歳であり，罹患眼の矯正視力は0.3，0.3，0.7であった。病期はYannuzziらの分類で，2眼が網膜色素上皮剝離を伴う第2期，1眼が第3期であった。結果：全例で滲出性変化が改善し，視力はそれぞれ0.9，1.0，0.8になった。第2期の2眼では，治療から3か月と7か月後に再発した。結論：網膜血管腫状増殖に対し，光線力学的療法とbevacizumab硝子体内投与の併用療法で，視力と滲出性病変を改善することができたが，再発への対策が必要である。

Abstract.　Purpose：To report the outcome of combined treatment with photodynamic therapy and intravitreal bevacizumab for retinal angiomatous proliferation（RAP）. Cases：Three eyes of 3 cases of RAP were treated. The series comprised 2 males and 1 female. They were aged 68, 69 and 90 years respectively. Corrected visual acuity was 0.3, 0.3 and 0.7 respectively. Two were in stage 2 with detachment of retinal pigment epithelium. One was in stage 3 after Yannuzzi. Results：All the 3 eyes showed improvement in exudative fundus lesion. Visual acuity improved to 0.9, 1.0 and 0.8 respectively. Two eyes in stage 2 recurred after 3 and 7 months respectively. Conclusion：Combined treatment with photodynamic therapy and intravitreal bevacizumab was effective for exudative fundus lesion and visual acuity in eyes with retinal angiomatous proliferation. Prevention of recurrence remains a major problem.