ベバシズマブ硝子体注射が奏効したCoats病の1例

Intravitreal injection of bevacizumab was effective in a case of Coats disease

要約　目的：滲出性網膜剝離を伴ったCoats病にベバシズマブ硝子体内注射が奏効した症例の報告。症例と所見：15歳男子が7日前からの左眼視力低下で受診した。矯正視力は右1.2，左1.5で，左眼黄斑部に硬性白斑が沈着し，上耳側の眼底に滲出性病変と出血を伴う異常血管があった。蛍光眼底造影で毛細血管の拡張と血管瘤があり，Coats病と診断した。レーザー光凝固ののち黄斑滲出が増加し，初診から13か月後に視力が0.08に低下した。ベバシズマブ1.25mgの硝子体内注射を2回行い，初診から25か月後の現在，視力は0.6に改善している。結論：滲出性網膜剝離があるCoats病の症例にベバシズマブの硝子体内注射が奏効した。

Abstract.　Purpose：To report the outcome of intravitreal injection of bevacizumab for exudative retinal detachment in a case of Coats disease. Case and Findings：A 15-year-old boy noted impaired visual acuity in the left eye since one week before. Corrected visual acuity was 1.2 right and 1.5 left. The left eye showed hard exudate in the macular area and abnormal retinal vessels with exudate and hemorrhage in the superior temporal quadrant. Fluorescein angiography showed dilated capillaries and microaneurysms,leading to the diagnosis of Coats disease. Laser photocoagulation was followed by exacerbation of macular exudation with visual acuity down to 0.08 15 months after his initial visit. The left eye was treated by 2 sessions of intravitreal injection of 1.25 mg bevacizumab. Visual acuity improved to 0.6 25 months after his firts visit. Conclusion：Intravitreal bevacizumab was effective for exudative retinal detachment in a case of Coats disease.