網膜静脈分枝閉塞に伴う黄斑浮腫に対するラニビズマブ硝子体注射の治療成績

Outcome of intravitreal injection of ranibizumab for macular edema in branch retinal vein occlusion

要約　目的：網膜静脈分枝閉塞（BRVO）に伴う黄斑浮腫に対するラニビズマブ硝子体注射（IVR）の効果を検討する。対象と方法：BRVOに伴う黄斑浮腫にIVRを行い，6か月間以上観察可能であった41例41眼を対象とし，初回IVR後1，3，6か月ならびに最終受診時の，視力と中心網膜厚，追加治療について検討した。対象の内訳は，初回治療眼が21眼，ベバシズマブからの切り替え例が20眼である。結果：全症例におけるIVR前の視力の平均logMAR値は0.46で，治療1，3，6か月後および最終受診時には0.34，0.31，0.30，0.25と改善傾向を示した。治療前の網膜厚は502.5μmで，治療1，3，6か月後および最終受診時には300.6μm，407.8μm，368.4μm，348.7μmと，いずれも有意な改善を示した（p＜0.05）。注射回数は平均2.4回であった。6か月後に小数視力0.5以上となった症例は全体の70％を占めた。結論：短中期的にはBRVOの黄斑浮腫の軽減と視機能の改善にIVRは有効である。

Abstract.　Purpose：To report the outcome of intravitreal injection of ranibizumab for macular edema in branch retinal vein occlusion（BRVO）. Cases and Method：This retrospective study was made on 41 eyes of 41 patients with BRVO treated by us in the past 9 months. The series comprised 21 males and 20 females. The age ranged from 39 to 94 years, average 67 years. Ranibizumab was used as the initial treatment in 21 eyes and was switched from bevacizumab in 20 eyes. Treatment was repeated when needed. Cases were fo-llowed up for 6 months or longer. Visual acuity was evaluated as logMAR. Results：Visual acuity averaged 0.46 before treatment, and 0.34, 0.31, 0.30 and 0.25 respectively after 1, 3, 6 months and later after treatment. The differences were significant（p＜0.05）. Foveal thickness as measured by optical coherence tomography averaged 502.5μm before treatment and 368.4μm after 6 months of treatment. The difference was significant（p＜0.05）. Patients received an average of 2.4 sessions of treatment. Decimal visual acuity of 0.5 or over was achieved by 70％ of patients. Conclusion：Intravitreal injection of ranibizumab was followed by improved visual acuity and reduced macular edema in eyes with BRVO.