Vogt-小柳-原田病（VKH）に続発する脈絡膜新生血管症に対してラニビズマブ硝子体注射が奏効した1症例

Intravitreal injection of ranibizumab was effective for choroidal neovascularization in a case of Vogt-Koyanagi-Harada disease

要約　目的：Vogt-小柳-原田病に併発した脈絡膜新生血管にラニビズマブの硝子体注射が奏効した症例の報告。症例：42歳男性が2週間前からの左眼視力低下で受診した。矯正視力は左右眼とも1.2であった。両眼に眼底周辺部に軽い夕焼け様の変化と，乳頭浮腫があった。HLA型はDR1とDR4が陽性で，眼底所見と合わせ，Vogt-小柳-原田病と診断した。14か月後に右眼に変視症が生じた。両眼とも強い夕焼け状眼底であり，右眼の中心窩に接して脈絡膜新生血管があった。2週間後に右眼視力が0.6に低下した。ラニビズマブの硝子体注射を行い，6週間後に視力は1.0に回復した。さらに5週後の再発に同様の治療を行い，以後5か月間，再発はない。結論：Vogt-小柳-原田病の晩期合併症として生じた脈絡膜新生血管に，ラニビズマブの硝子体注射が奏効した。

Abstract.　Purpose：To report a case of Vogt-Koyanagi-Harada disease with choroidal neovascularization that responded to intravitreal injection of ranibizumab. Case：A 42-year-old male presented with blurring in the left eye since 2 weeks before. Corrected visual acuity was 1.2 in either eye. Both eyes showed optic disc edema with mild depigmentation in the periphery. He was positive for DR1 and DR4 by HLA typing. He was diagnosed with Vogt-Koyanagi-Harada disease. He developed metamorphopsia in the right eye 14 months later. Both eyes showed sunset-glow fundus. The right eye showed choroidal neovascularization adjacent to the fovea. Visual acuity deceased to 0.6 two weeks later. Intravitreal injection of ranibizumab was followed by improvement of visual acuity to 1.0 six weeks later. Recurrence another 5 weeks later was similarly treated. There has been no recurrent for 5 months until present. Conclusion：Intravitreal injection of ranibizumab was effective for choroidal neovascularization in a case of Vogt-Koyanagi-Harada disease.