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目的:滲出型加齢黄斑変性(AMD)に対するアフリベルセプト硝子体内投与の治療成績を検討した。対象と方法:滲出型AMDに対しアフリベルセプト硝子体内投与を行い,6か月以上経過観察できた64例64眼(典型AMD16眼,ポリープ状脈絡膜血管症44眼,網膜血管腫状増殖4眼)を対象とした。平均年齢は75.0±8.3歳であった。視力はlogMARで評価し,0.3以上の変化を改善,悪化とした。結果:投与前平均視力がlogMARで0.44±0.41であったのに対し,投与後6か月の平均視力は0.38±0.38であり,有意に改善がみられた(p<0.01)。視力変化は6%が改善,92%が不変,2%が悪化であった。中心窩網膜厚も298μmから209μmと有意に減少した(p<0.01)。アフリベルセプトの平均投与回数は2.4回であった。結論:AMDに対するアフリベルセプト硝子体内投与は,滲出性変化の改善,視力維持に有効である。
Abstract. Purpose:The purpose of this study is to evaluate the effectiveness of intravitreal injection of aflibercept(IVA)for neovascular age-related macular degeneration(AMD). Cases and Method:Sixty-four eyes of 64 patients with neovascular AMD(16 eyes of typical AMD, 44 eyes of polypoidal choroidal vasculopathy and 4 eyes of retinal angiomatous proliferation)who underwent IVA and could be followed up for 6 months or longer, were enrolled. Averaged age was 75.0±8.3 years. All eyes underwent IVA in the PRN regimen, BCVA and central retinal thickness(CRT)on optical coherence tomography were measured periodically. Results:The mean BCVA at baseline was 0.44±0.41 and the BCVA at month 6 was 0.38±0.38, significantly improved compared with baseline(p<0.01). BCVA was improved by 0.3 or more logMAR units in 4 eyes(6%), in 59 eyes(92%)BCVA was unchanged and one eye deteriorated. Mean CRT significantly decreased from 298±83μm at baseline to 244±59μm at month 6(p<0.01). The mean number of IVA was 2.4 times. Conclusion:IVA in patients with neovascular AMD improved visual acuity and CRT.
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