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要約 目的:治療歴がない滲出型加齢黄斑変性に対し,アフリベルセプトの硝子体内投与を行った結果の報告。症例:加齢黄斑変性165例166眼を対象とした。男性111例112眼,女性54例で,年齢は51〜87歳,平均72歳である。78眼が典型加齢黄斑変性,77眼がポリープ状脈絡膜血管症,11眼が網膜血管腫状増殖であった。導入期にアフリベルセプトの硝子体内投与を4週ごとに連続3回行い,以後は必要に応じて追加投与した。視力はlogMARとして評価した。結果:平均視力は治療開始前0.43,3か月後0.36,6か月後0.36,9か月後0.38,12か月後0.33であり,導入期の視力が維持された。治療開始時と3か月後の平均視力は,典型加齢黄斑変性では0.51から0.43に,ポリープ状脈絡膜血管症では0.32から0.43に,網膜血管腫状増殖では0.59から0.49に変化した。結論:滲出型加齢黄斑変性に対するアフリベルセプトの硝子体内投与により,術後12か月間の視力が維持または改善した。
Abstract. Purpose:To report the visual outcome of intravitreal injection in eyes of exudative age-related macular degeneration(AMD)as the initial treatment. Cases and Method:This study was made on 166 eyes of 165 cases with AMD. The series comprised 112 eyes of 111 males and 54 female eyes. The age ranged from 51 to 87 years, average 72 years. Typical AMD was present in 78 eyes, polypoidal choroidal vasculopathy in 77 eyes, and retinal angiomatous proliferation in 11 eyes. Intravitreal injection of aflibercept was performed three times at the interval of 4 weeks, to be repeated later as needed. Visual acuity was evaluated as logMAR. Results:Visual acuity averaged 0.43 before treatment, 0.36 3 months later, 0.36 6 months later, 0.38 9 months later, and 0.33 after 12 months. These results show that visual acuity was maintained after start of treatment. Visual acuity before and 3 months after treatment changed from 0.51 to 0.43 in typical AMD, from 0.32 to 0.43 in polypoidal choroidal vasculopathy, and from 0.32 to 0.43 in retinal angiomatous proliferation. Conclusion:Visual acuity was maintained or improved for 12 months after intravitreal injection in eyes of exudative age-related macular degeneration(AMD).
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