オツジ　ツヨシ   OTSUJI TSUYOSHI   尾辻　剛    所属   関西医科大学  眼科学講座    職種   准教授
言語種別	英語
発表タイトル	The effect of intravitreal injection of aflibercept in a case of chronic central serous chorioretinopathy
会議名	The 8th APVRS Congress(第52回日本網膜硝子体学会総会)
学会区分	全国規模の学会
発表者・共同発表者	◎Koike N, Otsuji T, Nishimura T, Takahashi K
発表年月日	2013/12
開催地 （都市, 国名）	名古屋
概要	<PURPOSE> Chronic central serous chorioretinopathy (CSC) is associated with persistent subretinal fluid, extensive retinal pigment epithelium (RPE) atrophy and cystoid macular degeneration, and it sometimes leads to severe and irreversible visual loss. We report a case of chronic CSC treated with intravitreal injection of aflibercept (IVA) for untreatable cystoid macular edema (CME) lasting more than 5 years. <METHODS> A 62-year-old man presented with a complaint of progression of central scotoma in both eyes for 10 years. The patient was diagnosed with chronic CSC and received laser photocoagulation at the age of 25. On initial examination, best-corrected visual acuity (BCVA) was 0.15 in his right eye and 0.2 in his left eye measured with a Japanese standard decimal visual chart. Optical coherence tomography showed massive CME and foveal thinning, and fluorescein angiography demonstrated extensive atrophy of RPE in both eyes. There was no obvious leakage into the subretinal space. <RESULTS>The patient was observed for 5 years without improvement and showed progression of CME. IVA was given in both eyes once under adequate informed consent and CME was significantly decreased. <CONCLUSION>Recently, several reports have supported the efficacy of intravitreal injection of anti-vascular endothelial growth factor drugs (anti-VEGF drugs) such as bevacizumab and ranibizumab in for chronic CSC, but some reports suggested the effect of anti-VEGF drugs was not promising. In our patient, we demonstrated that IVA could promote the absorption of subretinal fluid. It was suggested that IVA may provide another treatment option for patients with chronic CSC. The results also suggested that VEGF may be involved in fluid leakage in patients with chronic CSC.