治療歴のないポリープ状脈絡膜血管症に対するラニビズマブ併用光線力学療法の治療成績

Outcome of photodynamic therapy with intravitreal ranibizumab as initial treatments for polypoidal choroidal vasculopathy

要約　目的：治療歴のないポリープ状脈絡膜血管症（PCV）に対するラニビズマブ硝子体注入（IVR）に光線力学療法（PDT）を併用した症例の6か月間の治療成績の報告。対象と方法：症例は治療歴のないPCV 17例17眼（男性15眼，女性2眼，平均年齢74歳）。投与前視力が0.1を超えた症例を視力良好群，0.1以下の症例を視力不良群とし，ETDRS視力と中心窩網膜厚（CRT）の評価を行った。導入期に月1回のIVRを3回（1回目は1週間後PDT併用）を施行後，維持期に再投与基準に則ってIVRを行った。結果：視力良好群ではCRTの減少に伴い視力の改善が得られたが，視力不良群ではCRTが減少したにもかかわらず視力が悪化する傾向にあった。結論：PCVに対するIVR併用PDTの短期成績は概ね良好であったが，視力不良例に対する本治療法の適応は慎重に検討すべきである。

Abstract.　Purpose：To report the six-month outcome of photodynamic therapy with intravitreal ranibizumab for polypoidal choroidal vasculopathy（PCV）. Cases and Method：This study was made on 17 eyes of 17 patients with PCV. The series comprised 15 males and 2 females. The age averaged 74 years. Ranibizumab was intravitreally injected at one-month interval during the initial 3 months and was repeated after the PrONTO study protocol. Cases were followed up for 6 months. Results：Ten eyes with initial visual acuity better than 0.1 resulted in improved visual acuity and decrease in central retinal thickness（CRT）. Seven eyes with initial visual acuity of 0.1 or less resulted in decreased visual acuity and CRT. Changes in visual acuity were significant between the two groups（p＜0.05）. Changes in CRT were not significant between the two groups. Conclusion：Photodynamic therapy with intravitreal ranibizumab was effective for PCV in eyes with initial visual acuity better than 0.1.