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 3.未熟児網膜症

重症未熟児網膜症に対する抗VEGF抗体併用硝子体手術

著者： 佐藤達彦¹ 日下俊次¹

所属機関： ¹大阪大学大学院医学系研究科感覚機能形成学

ページ範囲：P.298 - P.303

治療法の変遷

　未熟児網膜症（retinopathy of prematurity：ROP）は，未熟な網膜血管を基盤に発症する眼内血管新生病である。大部分の症例は自然寛解するものの，重症例では線維血管増殖を伴い，牽引性網膜剝離を発症して失明に至ることもある。Terry^1）による最初の報告以来，半世紀以上経過しているにもかかわらず，未だ病態の詳細なメカニズムは解明されておらず，完全に失明を防止するには至っていない。そればかりか，近年の周産期医療の発達に伴い，より未熟な児でも生存可能となり，今後も症例の増加と重症化が予想される。

　未熟児網膜症に対する治療は，網膜無血管領域に対する光凝固が基本であるが，十分な光凝固を施行しても新生血管の活動性が抑制しきれず，網膜剝離を併発する症例も存在する。これらの症例に対しては，輪状締結術や硝子体手術が行われてきたが，その手術成績は決して満足の得られるものではなかった（図1）^2～8）。

参考文献

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