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Verhalten von Drusen nach „internal limiting membrane peeling“

Drusen characteristics after internal limiting membrane peeling

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Zusammenfassung

Hintergrund

Einzelne Fallbeschreibungen berichten über das Verschwinden von Drusen nach Pars-plana-Vitrektomie (ppV) mit „internal limiting membrane (iLM) peeling“. Es soll das Verhalten von Drusen nach iLM-Peeling untersucht werden.

Material und Methoden

Retrospektiv wurden 527 Patienten untersucht, die im Zeitraum von 2004 bis 2012 eine ppV mit iLM-Peeling bei epiretinaler Gliose oder Makulaforamen erhalten haben. Mittels Fotovergleich wurde geprüft, ob ca. 2 bis 5 Monate postoperativ eine Abnahme der zentralen Drusen festzustellen war.

Ergebnisse

Elf von 527 Patienten zeigten zentrale makuläre Drusen, 4 Patienten überwiegend große Drusen (> 63 µm), 7 Patienten überwiegend kleine Drusen (≤ 63 µm). Nach iLM-Peeling waren bei einem Patienten die Drusen im Peelingbereich deutlich weniger geworden, ohne Änderung am Partnerauge. Bei allen anderen Patienten zeigte sich keine Veränderung (n = 6) oder eine leichte Drusenzunahme (n = 4) bei vergleichbarem Verlauf am Partnerauge.

Schlussfolgerung

In unserem untersuchten Kollektiv konnte die Annahme, dass es nach iLM-Peeling zu einer Abnahme der Drusen kommt, nicht bestätigt werden. Nur in einem Fall war eine Drusenreduktion im zentralen Bereich zu beobachten.

Abstract

Background

There are some reports showing isolated cases of drusen regression after pars plana vitrectomy (ppV) with peeling of the internal limiting membrane (iLM). Drusen characteristics after iLM peeling was investigated in this study.

Patients and methods

The data of 527 patients who had received iLM peeling between 2004 and 2012 were retrospectively collected and those patients with retinal drusen were selected for the study. Fundus photographs before and after vitrectomy due to a macular hole or epiretinal gliosis were compared and drusen arrangement in the peeling site was analyzed. The aim of the study was to show whether there was drusen regression 2–5 months after surgery.

Results

Out of the 527 patients 11 showed central macular drusen, 4 with confluent large drusen (> 63 µm diameter) and 7 with small hard drusen (≤ 63 µm diameter). One patient showed drusen regression after iLM peeling without any changes in the other eye and all other patients showed no differences in the drusen findings (n = 6) or even some additional drusen (n = 4) without drusen alterations in the other eye.

Conclusion

The results of this study could not confirm some reports showing drusen regression after iLM peeling in the peeling site in general and there was only one single case of central drusen regression.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. F. Lehmann, T. Jenisch, H. Helbig und M.A. Gamulescu geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    F. Lehmann, T. Jenisch, H. Helbig & M.A. Gamulescu

Authors
  1. F. Lehmann
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  2. T. Jenisch
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  3. H. Helbig
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  4. M.A. Gamulescu
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Correspondence to F. Lehmann.

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Lehmann, F., Jenisch, T., Helbig, H. et al. Verhalten von Drusen nach „internal limiting membrane peeling“. Ophthalmologe 112, 424–428 (2015). https://doi.org/10.1007/s00347-013-3007-7

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  • DOI: https://doi.org/10.1007/s00347-013-3007-7

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