網膜静脈閉塞による遷延性類囊胞状黄斑浮腫に対する硝子体ベバシズマブ投与の短期効果

Short-term outcome of intravitreal bevacizumab for protracted macular edema in retinal vein occlusion

要約　目的：遷延性黄斑浮腫を伴う網膜静脈閉塞症に対するベバシズマブ硝子体内投与の結果の報告。症例：各種治療に抵抗し，10か月以上遷延する類囊胞状黄斑浮腫を伴う網膜静脈閉塞6例6眼を対象とした。年齢は41～87歳（平均69歳）であり，網膜静脈分枝閉塞症3例と網膜中心静脈閉塞症3例であった。ベバシズマブを硝子体内に投与し，視力，黄斑部の網膜厚，黄斑部の体積を3か月後まで測定した。視力はlogMARで評価した。結果：視力，網膜厚，網膜容積は全例で1週間後に有意に改善した。黄斑浮腫は5眼で1か月後に再発した。浮腫が改善したが，視力が改善しない1眼には網膜色素上皮萎縮があった。結論：遷延性の黄斑浮腫でもベバシズマブの硝子体内投与により，一過性の浮腫と視力の改善が得られるが，高頻度に再発する。

Abstract.　Purpose：To report the outcome of intravitreal injection of bevacizumab for protracted macular edema in retinal vein occlusion. Cases and Method：This retrospective study was made on 6 eyes of 6 patients who had retinal vein occlusion with cystoids macular edema persisting for 10 months or longer. The age ranged from 41 to 87 years, average 69 years. Three eyes had branch retinal vein occlusion and 3 eyes had central retinal vein occlusion. The patients were followed up for 3 months after injection of bevacizumab and were checked for visual acuity, retinal thickness and retinal volume. Visual acuity was evaluated in terms of logMAR. Results：All the cases showed improvement in visual acuity, retinal thickness and volume. Cystoid macular edema recurred in 5 eyes one month later. One eye showed improvement in cystoids edema but not in visual acuity due to atrophy of retinal pigment epithelium. Conclusion：Intravitreal bevacizumab induced temporary improvement in macular edema and visual acuity only to be followed by recurrence in the majority of cases.