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要約 目的:網膜静脈分枝閉塞症(BRVO)の黄斑浮腫に対して,抗血管内皮増殖因子(VEGF)薬の硝子体注射と低侵襲黄斑光凝固凝固を行った結果の報告。
対象と方法:過去70か月間に当科で治療したBRVO 150眼のうち,低侵襲黄斑光凝固凝固と抗VEGF薬の硝子体注射を行った30例30眼を対象とした。男性15例,女性15例で,平均年齢は66.9歳である。抗VEGF薬の硝子体注射を1回ないし3回行った後,黄斑浮腫のある部位に低侵襲黄斑光凝固凝固を行った。視力はlogMARで評価した。
結果:30眼に対する1年間の抗VEGF薬の硝子体注射の回数は,平均3.0±1.4回で,光凝固の回数は平均1.2±0.4回であった。平均視力は,治療前の0.43±0.35から,12か月後の0.16±0.27に有意に改善した(p<0.001)。光干渉断層計で測定した中心窩網膜厚の平均は,治療前の410.7±149.2μmから12か月後の290.4±76.0μmに有意に減少した(p=0.001)。
結論:BRVOの黄斑浮腫に対する抗VEGF薬の硝子体注射と低侵襲黄斑光凝固の併用により,視力が向上し,中心窩網膜厚が減少し,硝子体注射の回数を減らすことができた。
Abstract Purpose:To report the outcome of treatment of macular edema secondary to branch retinal vein occlusion by intravitreal injection of anti-VEGF followed by minimally invasive macular photocoagulation.
Cases and Method:This retrospective study was made on 30 eyes of 30 cases who had macular edema secondary to branch retinal vein occlusion and who were part of 150 eyes treated by us in the past 70 months. These 30 eyes received intravitreal injections of anti-VEGF followed by minimally invasive photocoagulation for areas of macular edema. Visual acuity was evaluated in terms of logMAR.
Results:The 30 eyes received an average of 3.0±1.4 sessions of intravitreal VEGF, followed by 1.2±0.4 sessions of photocoagulation. Visual acuity averaged 0.43±0.35 before treatment and 0.16±0.27 after 12 months of treatment. The difference was significant(p<0.001). Central macular thickness, as measured by optical coherence tomography, averaged 410.7±149.2 μm before treatment and 290.4±76.0 μm 12 months after treatment. The difference was significant(p=0.001).
Conclusion:Treatment of macular edema secondary to branch retinal vein occlusion by intravitreal injection of anti-VEGF followed by minimally invasive macular photocoagulation resulted in improved visual acuity, reduced macular thickness, and reduced sessions of intravitreal anti-VEFG injection.
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