ベバシズマブ硝子体注射後網膜静脈分枝閉塞症に対するラニビズマブ硝子体注射の長期成績

Long-term outcome of intravitreal ranibizumab for branch retinal vein occlusion after intravitreal bevacizumab

要約　目的：ベバシズマブ硝子体注射（IVB）既往のある網膜静脈分枝閉塞症（BRVO）に対するラニビズマブ硝子体注射（IVR）の長期成績の報告。

対象と方法：黄斑浮腫（ME）を伴うBRVOに対してIVBの既往があり，MEの再発のためにIVRを施行し12か月以上経過観察できた13例13眼（男性5眼，女性8眼，平均年齢64.7歳）を対象とした。初回投与以降は必要に応じて再投与を行った。視力，中心窩網膜厚（CRT）について検討した。視力はlogMARで評価し，0.2以上の変化を改善または悪化とした。

結果：視力，CRTのいずれもIVR後1か月から24か月の期間で有意に改善した。IVR回数は平均4.6回で，最終視力は改善5眼，不変8眼であった。

結論：IVB既往があるBRVOに対しIVRは長期的な視力維持に有効であるが，多くの症例で再投与を要した。

Abstract　Objective: To report the long-term outcome of intravitreal ranibizumab injection（IVR）for branch retinal vein occlusion（BRVO）in patients with a history of intravitreal bevacizumab injection（IVB）.

Subjects and Methods: We studied 13 eyes of 13 patients（male, 5 eyes；female, 8 eyes；mean age, 64.7 years）with a history of IVB for BRVO with macular edema（ME）who received IVR and could be followed for over 12 months for recurrent ME. After the first IVR, re-injections were administered as needed. Visual acuity and central retinal thickness（CRT）were examined. Visual acuity was evaluatedemploying the logMAR chart, and increases or decreases of at least 0.2 were evaluated as improvement or deterioration, respectively.

Results: Visual acuity and CRT both improved significantly between 1 month and 24 months after IVR. The mean number of IVRs was 4.6. Final evaluation of visual acuity showed improvement in 5 eyes and no change in 8 eyes.

Conclusion: IVR was effective for long-term maintenance of visual acuity in patients with BRVO with a history of IVB. Many patients required re-injection.