多発性後極部網膜色素上皮症に対してベバシズマブ硝子体内注射を行った1例

A case of multifocal posterior pigment epitheliopathy treated by intravitreal bevacizumab

要約　目的：多発性後極部網膜色素上皮症（MPPE）に対し，ベバシズマブ硝子体内注射が奏効した症例の報告。症例：51歳男性が両眼の視力低下で紹介受診した。13年前から動揺する両眼視力低下を認め，前医でMPPEの診断で光凝固を受けていた。所見：矯正視力は右0.6，左0.4で，両眼に漿液性網膜剝離があり，左眼には網膜色素上皮剝離が併発していた。初診から3か月後に右眼の網膜浮腫が増悪し，視力が0.03に低下した。中心窩厚は1,134μmであった。ベバシズマブ硝子体内注射を1か月ごとに4回行った。視力は0.09に改善し，中心窩厚は120μmに減少した。左眼は漿液性網膜剝離が自然寛解し，視力は0.6に改善した。結論：MPPEの難治例にベバシズマブ硝子体内注射が奏効することがある。

Abstract.　Purpose：To report a case of bilateral multifocal posterior pigment epitheliopathy（MPPE）that responded to intravitreal bevacizumab. Case：A 51-year-old male presented with impaired visual acuity in both eyes. He had had repeated episodess of visual impairment in both eyes since 13 years before. He had been diagnosed with MPPE. Photocoagulation was not effective. Findings：Corrected visual acuity was 0.6 right and 0.4 left. Both eyes showed serous retinal detachment in the posterior fundus. Detachment of retinal pigment epithelium was present in the left eye. Retinal detachment in the right eye exacerbated 3 months later with visual acuity down to 0.03 and foveal thickness of 1,134μm. The right eye started receiving intravitreal bevacizumab at a monthly interval. Visual acuity started to improve after the third session to attain 0.09 with foveal thickness of 120μm. Retinal detachment in the left eye got well spontaneously to result in visual acuity of 0.6. Conclusion：This case illustrates that intravitreal bevacizumab may be effective for protracted MPPE.