原田病の経過中に生じた脈絡膜新生血管に対する抗VEGF薬の硝子体内投与を行った1例

Intravitreal injection of bevacizumab for choroidal neovascularization in a case of Vogt-Koyanagi-Harada disease

要約　目的：原田病の経過中に生じた脈絡膜新生血管に対し，ベバシズマブ硝子体注射（IVB）が奏効した症例の報告。症例：35歳女性が5週前からの霧視で受診した。矯正視力は右0.8，左1.2で，両眼に慢性化した前眼部炎症と夕焼け状眼底があった。原田病と診断し，両眼をステロイド薬で治療した。以後4回の再燃があり，1年後にステロイド大量療法を行った。左眼視力が0.5に低下し，歪視が生じた。左眼黄斑部に脈絡膜新生血管と漿液性網膜剝離があった。3回のバシズマブの硝子体注射で，視力は1.0に改善した。以後6か月後の現在まで経過は良好である。結論：遷延化した原田病に併発した脈絡膜新生血管に対し，ベバシズマブの硝子体注射が奏効した。

Abstract.　Purpose：To report a case of protracted Vogt-Koyanagi-Harada（VKH）disease who was treated by intravitreal bevacizumab for choroidal neovascularization. Case：A 35-year-old female presented with blurring of vision since 5 weeks before. Corrected visual acuity was 0.8 right and 1.2 left. Both eyes showed signs of chronic inflammation in the anterior chamber and sunset-glow fundus. The findings led to the diagnosis of VKH disease. She was treated by topical corticosteroid. Intraocular inflammation recurred 4 times during the ensuing one year. Metamorphopsia developed in the left eye following pulsed corticosteroid therapy. The affected eye showed choroidal neovascularization with serous retinal detachment. Visual acuity improved from 0.5 to 1.0 after 3 sessions of intravitreal injection of bevacizumab. She is doing well for 6 months until present. Conclusion：Intravitreal injection of bevacizumab was effective for choroidal neovascularization in a case of protracted VKH disease.