近視性脈絡膜新生血管に対するラニビズマブ療法の効果

Effect of intravitreal ranibizumab for myopic choroidal degeneration

要約　目的：ラニビズマブ硝子体内投与（IVR）を行った近視性脈絡膜新生血管（mCNV）の短期成績の報告。対象と方法：IVR後2か月以上経過観察ができたtreatment naïveのmCNV症例，26例26眼の視力，網膜厚，投与回数について後ろ向きに検討した。結果：視力はIVR前と1か月後で有意な改善がみられたが（p＜0.01），最終観察時では有意差はみられなかった。中心窩網膜厚，病巣部網膜厚は，1か月後，最終観察時ともに有意な改善がみられた（p＜0.01）。26眼中16眼が単回投与，10眼（38.5％）が複数回投与で，両群間の病変最大径に有意差はなく，病巣部網膜厚は複数回投与群が有意に厚かった（p＜0.05）。結論：IVRは有効な治療法であるが，複数回投与を要する症例があり，IVR後の綿密な経過観察と投与方法の検討が必要であると思われた。

Abstract.　Purpose：To report the short-term outcome of intravitreal injection of ranibizumab（IVR）for myopic choroidal neovascularization（mCNV）. Cases and Method：This retrospective study was made on 26 eyes of 26 patients who received intravitreal injections of ranibizumab for treatment naïve mCNV and observed over 2 months. The changes of visual acuity, retinal thickness and the number of IVR were evaluated. Results：Visual acuity improved significantly 1 month after treatment（p＜0.01）but it showed no significant difference at final visit. Retinal thickness of fovea and focus improved significantly throughout the follow-up period （p＜0.01）. In 26 eyes, 16 eyes（61.5％）were treated by single dose and 10 eyes（38.5％）were treated by multiple dose. The mean of retinal thickness of focus was significantly thicker in multiple-dose group than single-dose group（p＜0.05）but it showed no significant difference in the mean of greatest linear dimension between both groups. Conclusion：IVR for mCNV is effective but multiple-dose treatment was necessary in some cases. We suggested that careful observations after treatment and considerations of protocol of IVR were necessary.