アフリベルセプトからラニビズマブへスイッチバックした滲出型加齢黄斑変性の検討

Outcome of switchback from intravitreal aflibercept to ranibizumab in exudative age-related macular degeneration

要約　目的：滲出性加齢黄斑変性に対し，ラニビズマブ硝子体内投与からアフリベルセプト硝子体内投与に切り替えたが，治療に抵抗し，再度ラニビズマブ投与に切り替えた症例群の報告。

対象と方法：滲出性加齢黄斑変性に対し，ラニビズマブ硝子体内投与からアフリベルセプト硝子体内投与に切り替えた229眼のうち，治療に抵抗し，再度ラニビズマブ投与に切り替えた6例6眼を対象とした。男性と女性各3眼で，年齢は57〜90歳，平均69歳である。ラニビズマブ再投与に切り替えてから2か月間の視力と中心窩網膜厚を検討した。

結果：再切替前後の平均視力と中心窩網膜厚に有意な変化はなかった。1か月後に漿液性網膜剝離が2例で改善したが，いずれもその2か月後に再発した。

結論：滲出性加齢黄斑変性に対するラニビズマブへの再切替の効果は，限定的であった。

Abstract　Purpose: To present a review of cases of exudative age-related macular degeneration（AMD）who initially resisted to intravitreal ranibizumab, who then received aflibercept, and who were again treated by ranibizumab.

Cases and Method: This study was made on 6 eyes of 6 cases with AMD that received ranibizumab as switchback treatment. These 6 eyes were from a larger series of 229 eyes that received aflibercept switched from ranibizumab for AMD. There were 3 males and females. The age ranged from 57 to 90 years, average 69 years. These 6 eyes were evaluated regarding visual acuity and central retinal thickness for 2 months after switchback.

Results: There were no significant changes in visual acuity or central retinal thickness. Serous retinal detachment improved in 2 eyes one month after switchback and recurred after another 2 months.

Conclusion: There were no significant benefits after switchback from intravitreal aflibercept to ranibizumab in exudative age-related macular degeneration.