網膜静脈分枝閉塞症に伴う黄斑浮腫に対するラニビズマブ治療

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

要約　目的：網膜静脈分枝閉塞症（BRVO）に伴う黄斑浮腫に対するラニビズマブ硝子体投与の結果の報告。対象と方法：BRVO 10例11眼を対象とした。男性5眼，女性6眼で，年齢は平均68歳である。虚血型8眼，非虚血型3眼であり，2眼には光凝固，9眼にはトリアムシノロンテノン囊下注射の既往があった。視力はlogMARで評価し，0.2以上の変化を改善または悪化とした。中心窩網膜厚は20％以上の変化を改善または悪化とした．投与後2〜6か月間の結果を観察した．結果：ラニビズマブ投与前の視力は0.545で，投与後1〜6か月まで有意に改善した。中心窩網膜厚は投与前684μmで，投与後1〜6か月まで有意に改善した。漿液性網膜剝離は投与前7眼にあり，5眼で再投与を要した。結論：BRVOに伴う黄斑浮腫に対するラニビズマブ硝子体投与により，投与後6か月間の視力と中心窩網膜厚が有意に改善した。漿液性網膜剝離が併発しているときには，投与後の黄斑浮腫の再燃があった。

Abstract.　Purpose：To report the outcome of intravitreal injection of ranibizumab for macular edema secondary to branch retinal vein occlusion（BRVO）. Cases and Method：This study was made on 11 eyes of 10 patients with BRVO. The series comprised 5 male and 6 female eyes. The age averaged 68 years. BRVO was ischemic in 8 eyes and nonischemic in 3 eyes. Two eyes had received photocoagulation and 9 eyes had subTenon injection of triamcinolone acetonide. Visual acuity was evaluated logMAR. Changes by 0.2 or more were interpreted as improvement or deterioration. Changes by 20％ or more in foveal thickness were interpreted as improvement of deterioration. Cases were followed up for 2 to 6 months after treatment. Results：Visual acuity before treatment averaged 0.545. It improved after one to 6 months of treatment. Foveal thickness averaged 684μm before treatment. It improved after one to 6 months of treatment. Serous retinal detachment was initially present in 7 eyes. Intravitreal ranibizumab had to be repeated in 5 of these eyes. Conclusion：Visual acuity and foveal thickness improved up to 6 months after intravitreal ranibizumab. Eyes with serous retinal detachment tended to show recurrence of macular edema after ranibizumab.