両眼発症の近視性血管新生黄斑症に対して新生血管抜去術または抗VEGF抗体ベバシズマブ硝子体内投与を行った1例

A bilateral case of neovascular maculopathy with myopia treated by surgical removal of neovascular membrane and by intravitreal bevasizumab

要約　目的：両眼の近視性血管新生黄斑症に対し，新生血管抜去術またはベバシズマブの硝子体内投与を行った1例の報告。症例：53歳女性が左眼変視症で受診した。左右眼とも約－13Dの近視があり，矯正視力は右0.8，左0.4であった。左眼の中心窩耳上側に脈絡膜新生血管があった。結果：左眼に新生血管抜去術を行い，1か月後に視力は1.0に改善した。その後右眼の中心窩下に新生血管が発症し，視力が0.6に低下した。ベバシズマブを硝子体腔内に投与し，2週間後に視力が1.0になった。その10か月後，傍中心窩に新生血管が生じ，ベバシズマブの再投与で視力が改善した。結論：近視眼に発症した血管新生黄斑症に対し，ベバシズマブの硝子体内投与が奏効することがある。

Abstract.　Purpose：To report a bilateral case of neovascular maculopathy with myopia treated by surgical removal in one eye and by intravitreal bevacizumab in the other. Case：A 53-year-old female presented with metamorphopsia in her left eye. Both eyes had myopia of about －13 diopters. Her corrected visual acuity was 0.8 right and 0.4 left. The left eye showed choroidal neovascularization upper temporal to the fovea. Clinical Course：Surgical removal of neovascular tissue resulted in improved visual acuity to 1.0 one month later. The right eye then showed subfoveal neovascularization with visual acuity decreased to 0.6. Intravitreal bevacizumab was followed by improved visual acuity to 1.0 2 weeks later. Parafoveal neovascularization developed in the right eye another 10 months later. Similar procedure induced apparent cure. Conclusion：Intravitreal bevacizumab may be effective for neovascular maculopathy with myopia.