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Der Diabetologe

, Volume 14, Issue 8, pp 590–596 | Cite as

Therapie der proliferativen diabetischen Retinopathie

  • Norbert Bornfeld
Leitthema

Zusammenfassung

Die proliferative diabetische Retinopathie ist eine schwerwiegende Komplikation einer diabetischen Netzhauterkrankung und führt ohne Behandlung zu einem massiven Visusverlust bis hin zur funktionellen Erblindung. Bei rechtzeitiger Diagnose im Rahmen geeigneter Screeningmaßnahmen kann das Erblindungsrisiko durch eine stadiengerechte Therapie dramatisch reduziert werden. Dabei ist die panretinale Fotokoagulation unverändert der Goldstandard. Die intravitreale Anti-VEGF-Therapie (VEGF: „vascular endothelial growth factor“) ist zumindest in den ersten 2–3 Jahren Behandlungsdauer gegenüber der alleinigen panretinalen Fotokoagulation von Vorteil, insbesondere aufgrund der damit erreichbaren Regression neovaskulärer Veränderungen und einer Rückbildung des Makulaödems. Kommt es zu einer persistierenden Glaskörperblutung oder einer traktiven Ablösung der Netzhaut, ist eine Vitrektomie indiziert, die nicht verzögert werden darf, wenn die zentrale Netzhaut bedroht ist.

Schlüsselwörter

Sehstörungen Erblindung Fotokoagulation VEGF Vitrektomie 

Treatment of proliferative diabetic retinopathy

Abstract

Proliferative diabetic retinopathy is a serious complication of diabetic retinopathy and, without treatment, leads to complications ranging from massive loss of visual acuity to functional blindness. With timely diagnosis within the framework of suitable screening measures, the risk of blindness can be massively reduced by appropriate treatment. Panretinal photocoagulation remains the gold standard of therapy. Intravitreal anti-vascular endothelial growth factor (VEG) therapy has advantages over panretinal photocoagulation alone at least in the first 2–3 years of therapy, in particular as a result of the resolution of neovascular changes and macular oedema. If persistent vitreous haemorrhage or tractive retinal detachment occurs, vitrectomy is indicated, which must not be delayed if the central retina is threatened.

Keywords

Vision disorders Blindness Light coagulation Vascular endothelial growth factors  Vitrectomy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

N. Bornfeld hat für Rednertätigkeiten von den Firmen Novartis und Bayer Health Honorare bezogen.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für AugenheilkundeUniversitätsklinikum EssenEssenDeutschland

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