中心窩脈絡膜新生血管に対しラニビズマブが著効したVogt-小柳-原田病の1例

Intravitreal ranibizumab was effective for choroidal neovascularization in a case of Vogt-Koyanagi-Harada syndrome

要約　目的：Vogt-小柳-原田症候群（VKH）の症例に中心窩下の脈絡膜新生血管（CNV）が生じ，ラニビズマブの硝子体注射が奏効した報告。症例：56歳の女性が9年前に発症し遷延化したVKHで受診した。ステロイドの内服と点眼を受けていた。所見：矯正視力は右0.6，左0.4で両眼に虹彩炎の所見と夕焼け状眼底があった。経過：水晶体再建術を行い，視力は左右とも1.2に回復した。4年後に変視症が生じ，視力は右0.2，左0.5になり，蛍光眼底造影と光干渉断層計の所見などからCNVと診断した。ラニビズマブの硝子体注射を6か月間に3回行い，視力は0.5に回復した。以後6か月後の現在まで，経過は良好である。結論：遷延したVKHに発症したCNVに対し，複数回のラニビズマブ硝子体注射が奏効した。

Abstract.　Purpose：To report a case of Vogt-Koyanagi-Harada disease（VKH）who developed choroidal neovascularization（CNV）that responded to intravitreal ranibizumab. Case：A 56-year-old female was referred to us before. She had been treated by topical and systemic corticosteroid. Findings：Corrected visual acuity was 0.6 right and 0.4 left. Both eyes showed signs of chronic iritis and sunset-glow fundus. Clinical Course：Visual acuity improved to 1.2 in either eye following cataract surgery. Metamorphopsia developed 4 years later with visual acuity of 0.2 right and 0.5 left. Fluorescein angiography and optical coherence tomography showed findings of CNV. Right visual acuity improved to 0.5 following 3 sessions of intravitreal ranibizumab injection over 6 months. She has been doing well for 6 months until present. Conclusion：Repeated sessions of intravitreal ranibizumab was effective for CNV as late complication of VKH.