加齢黄斑変性に対するラニビズマブからアフリベルセプトへの切り替えでの有効例の検討

Cases with favorable outcome after switching from intravitreal ranibizumab to aflibercept for age-related macular degeneration

要約　目的：加齢黄斑変性（AMD）に対するラニビズマブからアフリベルセプトへの切り替えでの有効例の検討の報告。対象と方法：ラニビズマブの継続投与でも，滲出性変化が遷延化したAMDに対して，アフリベルセプトへの切り替えが有効となり，6か月間経過を追えた7例7眼を対象とした。切り替え後の視力と滲出性変化を検討した。結果：病型はすべてポリープ状脈絡膜血管症であった。切り替え前に比べ，視力は切り替え3か月後，4か月後および6か月後で有意に改善した。平均中心窩網膜厚は切り替え1か月後から有意に改善し，6か月後まで維持された。結論：遷延化した滲出性変化をもつAMDに対して，アフリベルセプトへの切り替えは有効であった。

Abstract.　Purpose：To report cases of age-related macular degeneration（AMD）that showed favorable clinical course after switching from intravitreal ranibisumab to aflibercept. Cases and Method：We reviewed 7 eyes of 7 cases of AMD with favorable outcome after switching from intravitreal ranibizumab to aflibercept. The series comprised 6 males and one female. The age ranged from 67 to 73 years, average 76 years. Exudative changes were present before switching and disappeared after switching. Results：All the 7 eyes were categorized as polypoidal choroidal vasculopathy. Visual acuity improved significantly 3, 4 and 6 months after switching. Foveal retinal thickness averaged 262±90μm before switching and decreased significantly to 173±50μm one month after switching. Significant decrease continued up to 6 months after switching. Conclusion：Switching from intravitreal ranibisumab to aflibercept was effective for AMD with presistent exudative lesion up to 6 months.