臨床眼科62巻11号

2008年10月発行

特集 網膜硝子体診療update Ⅳ．注目の疾患 1.加齢黄斑変性

網膜血管腫状増殖の概念と治療

著者： 髙橋寛二¹

所属機関： ¹関西医科大学眼科学教室

ページ範囲：P.250 - P.261

はじめに

　網膜血管腫状増殖（retinal angiomatous proliferation：RAP）は滲出型加齢黄斑変性の特殊型に分類される黄斑疾患^1）で，他病型よりも高齢者に多く，急速な病状進行と高い難治性を示す，比較的新しい疾患概念である。ここでは，最近発表されたRAPの新しい概念も含めて，RAPの疾患概念と治療の現況について述べる。

参考文献

1）厚生労働省網膜脈絡膜・視神経萎縮症調査研究班加齢黄斑変性診断基準作成ワーキンググループ：加齢黄斑変性の分類と診断基準．日眼会誌（印刷中）

2）Yannuzzi LA, Negrao S, Iida T et al：Retinal angiomatous proliferation in age-related macular degeneration. Retina 21：416-434, 2001

3）Gass JDM, Agarwal A, Lavina AM et al：Focal inner retinal hemorrhages in patients with drusen. An early sign of occult choroidal neovascularization and chorioretinal anastomosis. Retina 23：741-751, 2003

4）Truong SN, Alam S, Zawadzki RJ et al：High resolution fourier-domain optical coherence tomography of retinal angiomatous proliferation. Retina 27：915-925, 2007

5）Freund KB, Ho IV, Barbazetto IA et al：Type 3 neovascularization. The expanded spectrum of retinal angiomatous proliferation. Retina 28：201-211, 2008

6）Yannuzzi LA, Freund KB, Takahashi BS et al：Review of retinal angiomatous proliferation or type 3 neovascularization. Retina 28：375-384, 2008

7）Lafaut BA, Aisenbrey S, Broecke CV et al：Clinicopathological correlation of deep retinal vascular anomalous complex in age related macular degeneration. Br J Ophthalmol 84：1269-1274, 2000

8）Shimada H, Kawamura A, Mori R et al：Clinicopathological findings of retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol 245：295-300, 2007

9）Maruko I, Iida T, Saito M et al：Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144：12-22, 2007

10）Massacesi AL, Sacchi L, Bergamini F et al：The prevalence of retinal angiomatous proliferation in age-related macular degeneration with occult choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 246：89-92, 2008

11）Gross NE, Aizman A, Brucker A et al：Nature and risk of neovascularization in the fellow eye of patients with unilateral retinal angiomatous proliferation. Retina 25：713-718, 2005

12）Johnson TM, Glaser BM：Focal laser ablation of retinal angiomatous proliferation. Retina 26：765-772, 2006

13）Borrillo JL, Sivalingam A, Martidis A et al：Surgical ablation of retinal angiomatous proliferation. Arch Ophthalmol 121：558-561, 2003

14）Sakimoto S, Gomi F, Sakaguchi H et al：Recurrent retinal angiomatous proliferation after surgical ablation. Am J Ophthalmol 139：917-918, 2005

15）Shimada H, Mori R, Arai K et al：Surgical excision of neovascularization in retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol 243：519-524, 2005

16）Boscia F, Furio C, Sborgia L et al：Photodynamic therapy for retinal angiomatous proliferation and pigment epithelium detachment. Am J Ophthalmol 138：1077-1079, 2004

17）Silva RM, Cachulo ML, Figueria J et al：Chorioretinal anastomosis and photodynamic therapy：a two-year follow-up study. Graefes Arch Clin Exp Ophthalmol 245：1131-1139, 2007

18）Krebs I, Krepler K, Stolba U et al：Retinal angiomatous proliferation：combined therapy of intravitreal triamcinolone acetonide and PDT versus PDT alone. Graefes Arch Clin Exp Ophthalmol 246：237-243, 2008

19）Boscia F, Palodi MB, Furio C et al：Photodynamic therapy with verteporfin for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol 244：1224-1232, 2006

20）Klais CM, Eaqndi CM, Ober MD et al：Anecortave acetate treatment for retinal angiomatous proliferation：a pilot study. Retina 26：773-779, 2006

21）Meyerle CB, Freund KB, Iturralde D et al：Intravitreal bevacizumab（Avastin）for retinal angiomatous proliferation. Retina 27：451-457, 2007

22）Jeores S, Heussen FMA, Treziak T et al：Bevacizumab（Avastin）treatment in patients with retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol 245：1597-1602, 2007

23）Mahmood S, Kumar N, Lenfestey PM et al：Early response of retinal angiomatous proliferation treated with intravitreal pegaptanib：a retrospective review. Eye. 1-6, 2008

24）Lai TYY, Chan W-M, Liu DT et al：Ranibizumab for retinal angiomatous proliferation on neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 245：1877-1880, 2007

25）Moere A, Kak R, Sandhu SS et al：Anatomical and visual outcome of retinal angiomatous prolifetaion treated with photodynamic therapy and intravitreal triamcinolone. Am J Ophthalmol 143：701-704, 2007