硝子体手術前後に発症した血管新生緑内障に対するベバシズマブ硝子体注入

Intravitreal injection of bevacizumab for neovascular glaucoma before or after vitreous surgery

要約　目的：増殖糖尿病網膜症への硝子体手術前後に発症した血管新生緑内障へのべバシズマブ硝子体内注入の成績の報告。対象と方法：過去68か月間に増殖糖尿病網膜症に対して硝子体手術を行った17例23眼を対象とした。13眼には手術前に血管新生緑内障があり，ベバシズマブ注入を行った。10眼には手術後に血管新生緑内障が発症し，ベバシズマブを注入した。結果：ベバシズマブ注入により，虹彩新生血管は全例で1週間後に消退し，10眼（45％）で再発した。眼圧下降幅は術前よりも術後注入群で有意に大きかった。ベバシズマブ注入から2か月後の眼圧下降幅は両群間に差がなかった。結論：血管新生緑内障に対するベバシズマブ硝子体内注入は，硝子体手術前と後で同様な眼圧下降効果を示した。

Abstract.　Purpose：To report the outcome of intravitreal injection of bevacizumab for neovascular glaucoma（NVG）that became manifest before or after vitreous surgery for proliferative diabetic retinopathy（PDR）. Cases and Method：This retrospective study was made on 23 eyes of 17 cases that received vitreous surgery for PDR during the past 68 months. NVG was present in 13 eyes before surgery and received intravitreal bevacizumab. NVG became manifest in 10 eyes after surgery and received intravitreal bevacizumab. Results：Rubeosis iridis disappeared in all the 23 eyes one week after injection and recurred in 10 eyes（45％）during the follow-up. Rate of decrease of intraocular pressure（IOP）was greater in eyes that received after surgery than those before surgery. Decrease of IOP was the same in both groups 2 months after injection of bevacizumab. Conclusion：Intravitreal injection showed similar decrease of IOP when performed before or after vitreous surgery.