近視性脈絡膜新生血管に対する治療後に黄斑円孔網膜剝離が生じた2例

Two cases of macular hole retinal detachment following treatment for myopic choroidal neovascularization

要約　目的：強度近視に併発した脈絡膜新生血管の治療後に黄斑円孔網膜剝離が発症した2症例の報告。症例：いずれも女性で，年齢は70歳と61歳，眼軸長はそれぞれ28.82mmと29.61mmであった。それぞれ片眼の黄斑部に脈絡膜新生血管があった。1例には光線力学療法を行い，矯正視力が0.2から0.4に上昇したが，3年後に黄斑円孔網膜剝離が発症した。他の1例にはベバシズマブの硝子体注入を3回行い，矯正視力が0.1から0.2に改善したが，3回目の硝子体注入から3か月後に黄斑円孔網膜剝離が発症した。両症例とも硝子体手術で復位が得られた。結論：強度近視眼での脈絡膜新生血管の治療では，新生血管の縮小または拡大による黄斑部の牽引により，黄斑円孔が生じる可能性がある。

Abstract.　Purpose：To report two cases who developed macular hole retinal detachment following treatment for myopic choroidal neovascularization. Cases：Both were females aged 70 and 61 years respectively. They had axial length of 28.82 mm and 29.61 mm in the affected eyes. They showed choroidal neovascularization in one eye each. One case was treated by photodynamic therapy. Corrected visual acuity improved from 0.2 to 0.4. Macular hole retinal detachment developed 3 years later. The other case received intravitreal injection of bevacizumab. Visual acuity improved from 0.1 to 0.2. Macular hole retinal detachment developed 3 months after the third session of intravitreal injection. The retina became reattached in both cases after vitreous surgery. Conclusion：Macular hole retinal detachment is a liability following treatment for myopic choroidal neovascularization due to traction to the macula after regression or proliferation of choroidal neovascularization.