重症未熟児網膜症に対しベバシズマブ硝子体内投与を行った症例の検討

Review of intravitreal bevacizumab for severe retinopathy of prematurity

要約　目的：重症未熟児網膜症に対してベバシズマブの硝子体投与を行った症例群の報告。対象と方法：過去30か月間に治療した未熟児網膜症12例21眼を対象とした。ベバシズマブは，6眼には初回治療として，9眼には硝子体手術前に，2眼には僚眼への光凝固後に，4眼には強膜輪状締結術と同時に投与した。結果：初回治療としてベバシズマブを単独投与した6眼では正常血管が伸展し，寛解した。硝子体手術前に投与した9眼中6眼では網膜復位が得られた。僚眼への光凝固後に増殖膜が生じた2眼ではその進行が停止した。強膜輪状締結術と同時に投与した4眼では網膜剝離が復位した。硝子体手術前に投与した9眼中2眼では牽引性網膜剝離が進行した。結論：重症未熟児網膜症に対するベバシズマブの硝子体投与は有効であったが，その安全性は未定である。

Abstract.　Purpose：To report the outcome of intravitreal bevacizumab for severe retinopathy of prematurity（ROP）. Cases and Method：This retrospective study was made on 21 eyes of 12 cases who received intravitreal injection of bevacizumab for severe ROP during the past 30 months. Intravitreal bevacizumab was performed as the initial treatment in 6 eyes,before vitreous surgery in 9 eyes,after photocoagulation in the fellow eye in 2 eyes,and during scleral encircling in 4 eyes. Results：ROP regressed after physiological vascularization in 6 eyes that received bevacizumab as the initial treatment. The retina became reattached in 6 out of 9 eyes that received bevacizumab before vitreous surgery. ROP became static in 2 eyes after photocoagulation in the fellow eye. The retinal became reattached in 4 eyes that also received scleral encircling. Retinal detachment progressed in 2 out of 9 eyes after vitreous surgery. Conclusion：Intravitreal bevacizumab was effective for severe ROP.