網膜中心静脈閉塞症に伴う黄斑浮腫に対するベバシズマブ硝子体投与と視力予後

Visual acuity following intravitreal bevacizumab for central retinal vein occlusion with macular edema

要約　目的：黄斑浮腫がある網膜中心静脈閉塞症に対するベバシズマブの硝子体内投与後の視力の変化の報告。対象と方法：過去2年間にベバシズマブの硝子体内投与を行った黄斑浮腫を伴う網膜中心静脈閉塞症44例44眼を対象とした。男性19例，女性25例で，平均年齢は71歳である。必要に応じてベバシズマブの硝子体内投与を追加した。32眼が虚血型，12眼が非虚血型で，虚血型には汎網膜光凝固を行った。全例で3か月以上の経過を観察した。視力はlogMARで評価した。結果：44例中5例に血管新生緑内障が発症し，20例に網膜剝離が併発した。視力の平均値は治療前0.93，治療後0.76で，有意に改善した（p＝0.018）。中心窩厚の平均値は治療前483μm，治療後338μmで，有意に減少した（p＝0.0002）。結論：黄斑浮腫のある網膜中心動脈閉塞症に対してベバシズマブの硝子体内投与を行い，視力が有意に改善し，中心窩厚が有意に減少した。

Abstract.　Purpose：To report the outcome of intravitreal bevacizumab for central retinal vein occlusion（CRVO）with macular edema. Cases and Method：This retrospective study was made on 44 eyes of 44 cases of CRVO treated during the past 24 months. Macular edema was present in all the eyes. The series comprised 19 males and 25 females. The age averaged 71 years. Intravitreal injection of bevacizumab was performed, to be repeated when necessary. Out of the 44 eyes, 32 eyes were ischemic CRVO and 12 eyes were non-ischemic CRVO. Panretinal photocoagulation was performed on eyes with ischemic CRVO. Cases were followed up for 3 months or longer. Visual acuity was evaluated as logMAR. Results：Neovascular glaucoma developed in 5 eyes and retinal detachment in 20 eyes. Visual acuity averaged 0.93 before treatment and 0.76 after treatment. The difference was significant（p＝0.018）. Foveal thickness averaged 483μm before and 338μm after treatment. The difference was significant（p＝0.0002）. Conclusion：Visual acuity improved and foveal thickcness decreased following intravitreal bevacizumab for CRVO with macular edema.