白点状眼底に合併した脈絡膜新生血管に抗VEGF薬硝子体注射を施行した1例

Choroidal neovascularization in a case of fundus albipunctatus treated by intravitreal injection of anti-VEGF agents

要約　目的：白点状眼底に併発した脈絡膜新生血管に対し，抗VEGF薬の硝子体注射を行った症例の報告。症例：74歳男性が11日前からの左眼霧視と変視症で受診した。所見：矯正視力は右1.2，左0.9で，両眼の後極部眼底に白点が多発していた。左眼黄斑部に，網膜下出血と網膜剝離を伴う脈絡膜新生血管と思わる所見があった。左眼を白点状眼底に併発した脈絡膜新生血管と診断した。ラニビズマブの硝子体注射を4回行ったが病変が再発したため，アフリベルセプトの硝子体注射を3回行った。初診から12か月後の現在，網膜下出血は消失し，後極部の白点病巣は消失し，視力は0.6を維持している。結論：白点状眼底に併発した脈絡膜新生血管に対し，抗VEGF薬の硝子体注射を複数回行い，脈絡膜新生血管が退縮した。

Abstract.　Purpose：To report a case of fundus albipunctatus who developed choroidal neovascularization and who received vitreal injection of anti-VEGF agents. Case：A 74-year-old male presented with blurring and metamorphopsia in the left eye since 11 days before. Findings：Corrected visual acuity was 1.2 right and 0.9 left. Both eyes showed numerous white dots in the posterior fundus area. The left macula showed choroidal neovascularization with subretinal hemorrhage and retinal detachment. He was diagnosed as fundus albipunctatus with choroidal neovascularization. The left eye received 4 sessions of intravitreal injection of ranibizumab. Recurrence was treated by 3 sessions of aflibercept. Subretinal hemorrhage and white dots disappeared with visual acuity of 0.6 for 12 months until present. Conclusion：Choroidal neovascularization in a case of fundus albipunctatus subsided after multiple sessions of intravitreal injection of ranibizumab and aflibercept.