近視性脈絡膜新生血管に対する抗VEGF薬投与後の網膜構造の経時的変化

Structural changes of the retina following treatment with anti-VEGF for myopic choroidal neovascularization

要約　目的：近視性脈絡膜新生血管（mCNV）への抗VEGF薬硝子体注射後の網膜構造変化の検討。

対象と方法：mCNVに対して硝子体注射を施行され6か月以上経過観察可能であった13例15眼。硝子体注射前および術後1，3，6か月の網膜構造変化について光干渉断層計を用いて後ろ向きに検討した。

結果：術前の滲出性変化として最多は網膜下滲出物（SRE），次いで網膜下液（SRF）で各々14眼（93％），8眼（53％）に認めた。術後1か月ではSREは4眼（27％），SRFは1眼（7％）に減少。CNVは術後1か月で7眼（50％），6か月で9眼（64％）が高輝度ラインで完全に囲い込まれた。

結論：mCNVの活動性評価にSREおよびCNV周囲の高輝度ライン所見が有用である可能性が示された。

Abstract　Purpose：To report structural changes of the retina following treatment with intravitreal anti-VRGF for myopic choroidal neovascularization.

Cases：This retrospective study was made on 15 eyes of 13 cases who received intravitreal injections of ranibizumab or aflibercept for myopic choroidal neovascularization and who were followed up for 6 months or longer. The eyes were evaluated by optical coherence tomography（OCT）using either Spectralis^TM or RTVue-100^TM before and 1, 3, and 6 months after start of treatment.

Results：Before treatment, OCT showed subretinal exudate in 14 eyes（93％）and subretnal fluid in 8 eyes（53％）. One month after start of treatment, subretinal exudate was present in 4 eyes（27％）and subretinal fluid in one eye（7％）. Choroidal neovascularization was sharply surrounded by well-delineated hyperreflective line in 7 eyes（50％）one month and in 9 eyes（64％）6 months of treatment.

Conclusion：The findings show that the activity of myopic choroidal neovascularization can be assessed by the presence of subretinal exudate and well-delineated hyperreflective line surrounding the choroidal neovascularization.