網膜細動脈瘤へのベバシズマブ硝子体内注射の効果

Outcome of intravitreal bevacizumab for ruptured retinal arterial macroaneurysm

要約　目的：網膜細動脈瘤破裂に対するベバシズマブ硝子体内注射の効果の報告。対象と方法：網膜細動脈瘤破裂が生じた6例6眼を対象とした。年齢は59～89歳（平均75歳）である。4眼にはベバシズマブ硝子体内注射を行い，2眼にはさらに硝子体内ガス注入を行った。網膜光凝固は行わなかった。結果：黄斑部の漿液性網膜剝離は全例で3か月以内に消失した。6例中5例で視力が向上し，網膜細動脈瘤は検眼鏡的に萎縮化した。出血が黄斑に及んでいた4眼中1眼では黄斑萎縮が生じ，視力が向上しなかった。結論：網膜細動脈瘤破裂では，光凝固を施行しなくても，ベバシズマブ硝子体内注射で黄斑部の漿液性網膜剝離が早期に消失した。

Abstract.　Purpose：To report the outcome of intravitreal bevacizumab for ruptured retinal arterial macroaneurysm. Cases and Method：This retrospective study was made on 6 eyes of 6 cases with ruptured retinal arterial macroaneurysm. The age ranged from 59 to 89 years,average 75 years. Four eyes were treated by intravitreal injection of bevacizumab. Two eyes received additional gas injection in the vitreous. No eyes received photocoagulation. Results：Serous retinal detachment in the macular area disappeared within 3 months in all the eyes. Visual acuity improved in 5 out of 6 eyes. Macroaneurysm became fibrotic by funduscopy in all the eyes. Macular atrophy with poor visual acuity developed in one out of 4 eyes that had hemorrhage involving the macula. Conclusion：Intravitreal injection of bevacizumab induced early resolution of serous retinal detachment in eyes with ruptured retinal arterial macroaneurysm.