滲出型加齢黄斑変性に対するラニビズマブ硝子体投与併用光線力学療法の6か月経過

Six-month outcome of photodynamic therapy with intravitreal ranibizumab for exudative age-related macular degeneration

要約　目的：滲出型加齢黄斑変性（AMD）に対するラニビズマブ硝子体投与併用光線力学療法（PDT）の結果の報告。対象と方法：滲出型AMD 45例45眼を対象とした。男性36眼，女性9眼で，年齢は53～90歳（平均72歳）である。6か月以上の経過を追跡した。結果：ラニビズマブの平均硝子体投与回数は2.56回，PDTの平均回数は1.10回であった。平均logMAR値は治療前0.57，治療後0.34と有意に改善し（p＜0.01），平均中心窩網膜厚は治療前428μm，治療後248μmと有意に減少した（p＜0.01）。治療6か月後におけるlogMAR値0.3以上の視力変化では改善40.0％，維持57.8％，悪化2.2％であった。結論：AMDに対するラニビズマブ硝子体投与併用光線力学療法は，短期的に視力の改善および滲出性変化の改善に有効である。

Abstract.　Purpose：To report the 6-month outcome of photodynamic therapy（PDT）combined with intravitreal ranibizumab for exudative age-related macular degeneration（AMD）. Cases and Method：This study was made on 45 eyes of 45 patients,comprising 36 males and 9 females. The age ranged from 53 to 90 years,average 72 years. Cases were followed up for 6 months. Visual acuity was evaluated in terms of logMAR. Results：Each patient received an average of 1.10 sessions of PDT and 2.56 of ranibizumab during a 6-months period. Visual acuity improved in 18 eyes（40％）,remained unchanged in 26 eyes（58％）,and deteriorated in one eye（2％）. Corrected visual acuity averaged 0.57 initially and 0.34 six months later. The difference was significant（p＜0.01）. Central macular thickness averaged 548μm initially and 248μm six months later. The difference was significant（p＜0.01）. There was no complication throughout. Conclusion：Combined treatment with PDT and intravitreal ranibizumab was effective in improving or maintaining visual acuity in eyes with AMD for 6 months.