抗血管内皮増殖因子薬硝子体注射後の眼圧および視野変化

Intraocular pressure and visual field after intravitreal injection of anti-vascular endothelial growth factor

要約　目的：抗血管内皮増殖因子（anti-VEGF）の硝子体内注入後の眼圧と視野変化の報告。対象と方法：滲出型加齢黄斑変性に対して抗血管内皮増殖因子の硝子体注射を過去8か月間に行った延べ81眼を対象とした。ペガプタニブを12眼，ラニビズマブを49眼，ベバシズマブを20眼に用い，注入量は0.05または0.09mlとした。非接触眼圧計で眼圧が正常化するまで全例で測定し，Humphrey自動視野計で40眼の視野を測定した。結果：全例で注射直後の平均眼圧が約50から65mmHgに上昇し，無処置で60分以内に20mmHgになった。注射前後で視野に変化はなかった。結論：抗血管内皮増殖因子の硝子体注入で眼圧が上昇するが，1時間以内に正常化し，視野への影響はない。

Abstract.　Purpose：To report changes in intraocular pressure（IOP）and visual field after intravitreal injection of anti-vascular endothelial growth factor（anti-VEGF）. Cases and Method：This study was made on eyes that received intravitreal injection of anti-VEGF preparations for age-related macular degeneration in 81 sessions in the past 8 months. Twelve eyes received pegaptanib,49 eyes received ranibizumab,and 20 eyes received bevacizumab. The amount of injection ranged from 0.05 to 0.09 ml. IOP was measured using a noncontact tonometer in all the eyes until IOP returned below 20 mmHg. Visual field was measured by Humphrey perimeter in 40 eyes. Results：Averaged IOP rose to about 50 to 65 mmHg in the 3 groups but returned to 20 mmHg or less after 60 minutes. There was no change in visual field before and after treatment. Conclusion：IOP is elevated after intravitreal injection of anti-VEGF. It decreases below 20 mmHg within one hour of injection. The injection does not induce changes in visual field.