ポリープ状脈絡膜血管症の低照射エネルギー光線力学的療法9か月後に漿液性網膜剝離再発と脈絡膜菲薄化が生じた1例

Recurrence of serous retinal detachment with choroidal thinning nine months after reduced fluence photodynamic therapy in a case of polypoidal choroidal vasculopathy

要約　目的：ポリープ状脈絡膜血管症に対して光線力学療法が行われ，9か月後に漿液性網膜剝離が再発し，脈絡膜が菲薄化した症例の報告。症例：72歳女性が6か月前からの右眼視力低下で受診した。矯正視力は右0.15，左1.5で，右眼黄斑部に橙赤色の隆起と漿液性網膜剝離があった。諸検査の結果，ポリープ状脈絡膜血管症と診断し，4か月の間隔で低出力光線力学療法とラニビズマブの硝子体注射を行った。2回目の治療から9か月後に漿液性網膜剝離が再発し，脈絡膜厚は減少していた。以後ラニビズマブの硝子体注射を毎月1回15か月間続けたが，ポリープ状脈絡膜血管症が再発し，脈絡膜厚が再度増加した。結論：ポリープ状脈絡膜血管症の治療経過中に，脈絡膜厚が増減した。

Abstract.　Purpose：To report recurrence of serous retinal detachment with choroidal thinning 9 months after reduced fluence photodynamic therapy in a case of polypoidal choroidal vasculopathy（PCV）. Case：A 72-year-old female presented with impaired visual acuity in the right eye of 6 months' duration. Corrected visual acuity was 0.15 right and 1.5 left. The right eye showed elevated orange-colored lesion with serous retinal detachment in the macula. Under the diagnosis of PCV, the right eye was treated by two sessions of low-output photodynamic therapy with intravitreal injection of ranibizumab. Retinal detachment with choroidal thinning recurred 9 months after the second treatment. The recurrence was treated by monthly intravitreal injection of ranibizumab. PCV recurred 15 months later with thinning of the choroid. Conclusion：Choroidal thickness may change during the course of treatment for PCV.