漿液性網膜色素上皮剝離を伴う加齢黄斑変性に対するラニビズマブの有効性についての検討

Outcome of intravitreal ranibizumab for age-related macular degeneration with serous detachment of retinal pigment epithelium

要約　目的：漿液性網膜色素上皮剝離を伴う加齢黄斑変性に対するラニビズマブ硝子体内注射の効果の報告。対象と方法：漿液性網膜色素上皮剝離を伴う加齢黄斑変性10例10眼にラニビズマブ硝子体内注射を行った。網膜色素上皮剝離の大きさは，1乳頭径2眼，2乳頭径1眼，3乳頭径3眼，3乳頭径以上が4眼であった。光干渉断層計により効果を判定した。視力はlogMARで評価し，0.2以上の変化を改善または悪化とした。結果：網膜色素上皮剝離は5眼で消失し，うち3眼で再発した。1眼で縮小し，4眼で不変であった。全10眼での最終視力は，2眼で改善し，8眼で不変であり，悪化はなかった。結論：漿液性網膜色素上皮剝離を伴う加齢黄斑変性に対するラニビズマブ硝子体内注射は，視力を向上または悪化防止させるが，病変が再発することがある。

Abstract.　Purpose：To report the outcome of intravitreal ranibizumab for age-related macular degeneration（AMD）with serous detachment of retinal pigment epithelium（RPE）. Cases and Method：This study was made on 10 eyes of 10 patients who received intravitreal injection of ranibizumab for AMD with serous RPE detachment. The size of RPE detachment was 1 disc diameter（DD）in 2 eyes,2DD in 1 eye,3DD in 3 eyes,and more than 3DD in 4 eyes. The effect of treatment was evaluated using optical coherence tomography. Visual acuity was evaluated in terms of logMAR. Changes by 0.2 or greater was judged as improvement or deterioration. Results：RPE detachment disappeared in 5 eyes,of which 3 eyes showed recurrence. It became smaller in one eye and remained unchanged in 4 eyes. Improvement became apparent after one session in 2 eyes and after 2 sessions in 3 eyes. Visual acuity improved in 2 eyes and remained unchanged in 8 eyes. Conclusion：Intravitreal ranibizumab was effective for AMD with serous RPE detachment. Recurrence is a major problem.