臨床眼科70巻1号

2016年01月発行

連載 今月の話題

糖尿病黄斑浮腫に対するレーザー治療の意義

著者： 高村佳弘¹

所属機関： ¹福井大学医学部眼科学教室

ページ範囲：P.5 - P.12

　視機能を直接脅かす糖尿病黄斑浮腫に対しては，以前は光凝固が唯一の手段であったが，過剰凝固の弊害もあり，近年は抗血管内皮増殖因子（vascular endothelial growth factor：VEGF）治療がその中心となっている。しかしその薬理効果には時間的な限界があり，効果を維持するためには頻回投与が必要となる。VEGF産生の場である虚血領域への光凝固は抗VEGF治療後の浮腫の再発を抑制することを可能とする。ただし，光凝固は一過性の炎症の惹起とそれに伴い浮腫の悪化を引き起こす危険性があり，それを抑制する手法としてはステロイド治療の併用が有効である。本稿では，糖尿病黄斑浮腫の治療におけるレーザー治療の新しい流れと抗VEGF治療との併用の意義について論じたいと思う。

参考文献

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