Spektrum der Augenheilkunde

, Volume 21, Issue 2, pp 128–132 | Cite as

Intravitreale Pharmakotherapie retinaler Erkrankungen und Komplikationen intravitrealer Injektionen

  • S. F. Egger
  • C. Ortner
  • C. Nischler
  • C. Hufnagel
  • J. Spaun
  • G. Grabner
State of the Art (Netzhautdiagnose und -therapie)
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Zusammenfassung

HINTERGRUND: Der Medikamentenapplikation direkt in den Glaskörper kommt bei zahlreichen retinalen Erkrankungen ein immer höher werdender Stellenwert zu. Die verschiedenen Indikationen und Komplikationsrisiken werden erläutert. RESULTATE: Vascular endothelial growth factor – A (VEGFA) spielt eine entscheidende Rolle in der Ausbildung choroidaler Neovaskularisationsmembranen (CNV). Es wurden daher verschiedene Anti-VEGF Substanzen entwickelt, die im Rahmen der altersbedingten Makuladegeneration (AMD) zur Therapie der CNV eingesetzt und direkt in den Glaskörper appliziert werden. Im besonderen handelt es sich dabei um das Aptamer Pegaptanib, das monoklonale Antikörperfragment Ranibizumab, und den monoklonalen Antikörper Bevacizumab. Intravitreal wird aber auch häufig das kristalline Steroid Triamcinolon vorwiegend zur Behandlung von Makulaödemen verschiedenster Genese appliziert. Komplikationsrisken betreffen insbesondere den Anstieg des Augeninnendruckes, Kataraktentwicklung und Endophthalmitis. SCHLUSSFOLGERGUNGEN: Durch intravitreale Pharmakotherapie können zahlreiche retinale Erkrankungen in ihrem Verlauf positiv beeinflusst werden. Da es sich aber dabei um einen prinzipiell mit zahlreichen Komplikationsrisiken behafteten Eingriff handelt, muss auf sorgfältige Injektionstechnik und sterile Bedingungen größtes Augenmerk gelegt werden.

Schlüsselwörter

Intravitreale Therapie Anti-VEGF Triamcinolon Komplikationen 

Intravitreal pharmacotherapy of retinal diseases and complications of intravitreal injections

Summary

BACKGROUND: Recent advances in the treatment of various retinal diseases necessitate the intravitreal application of drugs. Indications and possible complications will be discussed. RESULTS: Vascular endothelial growth factor – A (VEGFA) is crucial in the development of choroidal neovascularisations (CNV). Therefore different anti-VEGF drugs have been developed, in particular for treatment of CNV in age related macular degeneration (AMD), which have to be injected into the vitreous cavity. Among these are the aptamer pegaptanib, the monoclonal antibody-fragment ranibicumab and the monoclonal antibody bevacizumab. Additionaly the crystalline steroid triamcinolon is frequently injected into the vitreous body for treatment of macular oedema. Complications include in particular the rise of intraocular pressure, development of cataract and endophthalmitis. CONCLUSIONS: Intravitreal therapy offers the possibility to treat and improve numerous retinal diseases. Because this treatment has a risk of potentially devastating complications, one has to be very careful especially concerning the injection technique and sterile application-conditions.

Key words

Intravitreal Therapy Anit-vegf Triamcinolon Complications 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • S. F. Egger
    • 1
  • C. Ortner
    • 1
  • C. Nischler
    • 1
  • C. Hufnagel
    • 1
  • J. Spaun
    • 1
  • G. Grabner
    • 1
  1. 1.Universitätsklinik für Augenheilkunde und OptometriePrivate Medizinische Universität SalzburgSalzburgAustria

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