臨床眼科76巻11号

2022年10月発行

増刊号 最新臨床研究から探る眼科臨床のギモンQ＆A 5　網膜硝子体

増殖糖尿病網膜症に対する抗VEGF療法の効果は？

著者： 津田祐希¹ 中尾新太郎²

所属機関： ¹長崎市立病院機構長崎みなとメディカルセンター眼科 ²国立病院機構九州医療センター眼科

ページ範囲：P.210 - P.213

わが国では保険適用外ですが，短期的な視力予後に関しては汎網膜光凝固（PRP）に劣りません．PRPと比較して視野感度を保ち，硝子体手術の必要性を低下させる可能性があります．しかし，経済的側面や来院回数の課題もあり，長期的な評価が求められます．

参考文献

1）Writing Committee for the Diabetic Retinopathy Clinical Research Network et al：Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy：a randomized clinical trial. JAMA 314：2137-2146, 2015

2）Sivaprasad S et al；CLARITY Study Group：Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks（CLARITY）：a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. Lancet 389：2193-2203, 2017

3）Gross JG et al；Diabetic Retinopathy Clinical Research Network：Five-year outcomes of panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy：a randomized clinical trial. JAMA Ophthalmol 136：1138-1148, 2018

4）Halim S et al：Topographical response of retinal neovascularization to aflibercept or panretinal photocoagulation in proliferative diabetic retinopathy：post hoc analysis of the CLARITY Randomized Clinical Trial. JAMA Ophthalmol 139：501-507, 2021

5）Fallico M et al：Intravitreal anti-vascular endothelial growth factors, panretinal photocoagulation and combined treatment for proliferative diabetic retinopathy：a systematic review and network meta-analysis. Acta Ophthalmol 99：e795-e805, 2021

6）Hutton DW et al；DRCR Retina Network：Five-year cost-effectiveness of intravitreous ranibizumab therapy vs panretinal photocoagulation for treating proliferative diabetic retinopathy：a secondary analysis of a randomized clinical trial. JAMA Ophthalmol 137：1424-1432, 2019