網膜中心静脈閉塞に伴う黄斑浮腫に対するラニビズマブ硝子体注射の治療成績

Outcome of intravitreal ranibizumab for macular edema in central retinal vein occlusion in the Japanese

要約　目的：網膜中心静脈閉塞（CRVO）に伴う黄斑浮腫に対するラニビズマブ硝子体注射（IVR）の効果の報告。対象と方法：CRVOに伴う黄斑浮腫にIVRを行い，6か月間以上観察可能であった12例12眼を対象とし，初回IVR後1，3，6か月の視力と中心網膜厚，追加治療について検討した。対象の内訳は初回治療眼が8眼，ベバシズマブからの切り替え例が4眼である。結果：全症例におけるIVR前の視力の平均logMAR値は0.72で，治療1，3，6か月後には0.43，0.37，0.35と有意に改善した。治療前の中心網膜厚は610.7μmで，治療1，3，6か月後には287.9μm，330.2μm，281.5μmと，いずれも有意に改善した（p＜0.01）。注射回数は平均3.0回であった。6か月後に小数視力0.5以上となった症例は全体の58％を占めた。結論：短中期的にはCRVOの黄斑浮腫の軽減と視機能の改善にIVRは有効である。

Abstract.　Purpose：To report the outcome of intravireal injection of ranibizumab（IVR）for macular edema in central retinal vein occlusion（CRVO）in the Japanese. Cases and Methods：This retrospective study was made on 12 eyes of 12 patients with CRVO. Eight cases were treatment-naïve and 4 cases were switched from intravitreal bevacizumab. Each eye received 0.5 mg IVR, to be repeated as necessary. Visual acuity was evaluated as logMAR. Cases were followed up for 6 months after initial IVR. Results：Best corrected visual acuity（BCVA）and central foveal thickness averaged 0.72 and 610.7μm respectively before treatment. After 6 months of treatment, BCVA and central foveal thickness averaged 0.35 and 281.5μm respectively. The differences were significant（p＜0.01）. The number of IVR sessions averaged 3.0. Final BCVA in digits was 0.5 or over in 7 eyes（58％）. Conclusion：IVR was effective for macular edema secondary to CRVO up to 6 months.