Intravitreal Injection Bevacizumab for Vogt-Koyanagi-Harada Disease Complicated with Macular Choroidal Neovasculization - A Case Report

玻璃體內注射癌思停用於治療原田氏（Vogt-Koyanagi-Harada）症併發的黃斑部脈絡膜新生血管－病例報告

王世豪(Shih-Hao Wang) ； 陳勇仁(Yung-Jen Chen)

《中華民國眼科醫學會雜誌》 51卷1期 (2012/03) Pp. 118-124

https://doi.org/10.30048/ACTASOS.201203.0018

摘要

目的：報告一例（Vogt-Koyanagi-Harada）症病患，併發黃斑部脈絡膜新生血管並接受玻璃體內注射癌思停治療的病例報告。方法：病歷報告。結果：一位27歲的男性，本身並無特殊內科疾病，因左眼視力模糊兩週，伴隨頭痛和耳鳴的症狀而求診。當時左眼主觀視力為0.03。根據眼底螢光血管攝影以及臨床檢查診斷為原田氏症。在一年的追蹤之後發現復發的視力減退以及黃斑出血。眼底螢光血管攝影顯示有一黃斑部新生血管。左眼在接受玻璃體內注射2.5毫克癌思停後，18個月的術後追蹤此病患的視力都能穩定維持在0.5。結論：我們認為玻璃體內注射2.5毫克癌思停對於原田氏症併發的脈絡膜新生血管是一個有效的治療方法。並發現在一開始的眼底螢光血管攝影中如果有明顯的高螢光現象，也許暗示我們以後有生成脈絡膜新生血管的可能。

並列摘要

Purpose: To present a case of Vogt-Koyanagi-Harada (VKH) disease with secondary macular choroidal neovascularization (CNV), received intravitreal injection with Bevacizumab (Avastin).Method: A case report.Results: A 27-year-old man who had no known underlying disease suffered from blurred vision of his left eye for 2 weeks, accompanied with headache and tinnitus. His visual acuity decreased to 0.03 in left eye. VKH disease was diagnosed according to fluorescein angiography (FA) and clinical examinations. Decreased vision and macular hemorrhage were noted after one year follow-up. FA revealed a choroidal neovascularization (CNV) at the macular area. Intravitreal injection of 2.5mg Bevacizumab was performed for the left eye and the visual acuity has remained stable (best-corrected visual acuity; 0.5) through 18 months follow-up post-operatively.Conclusion: Our results suggest that intravitreal injection of 2.5mg Bevacizumab can be an effective method for treating CNV secondary to VKH disease. The obvious hyperfluorescence at macula area on FAG may imply the further formation of secondary CNV.

並列關鍵字

Vogt-Koyanagi-Harada disease ； choroidal neovasculization ； Bevacizumab