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Therapien retinaler Venenverschlüsse — ein Überblick

Therapeutical concepts in retinal vein occlusions — an overview

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Zusammenfassung

Der retinale Venenverschluss ist eine schwerwiegende Erkrankung für die es noch keine risikofreie Therapie gibt. Der natürliche Verlauf kann zum totalen Sehverlust führen. Das Ziel aller therapeutischen Maßnahmen ist es, das Sehvermögen soweit wie möglich aufrecht zu erhalten und das Entstehen von Komplikationen zu vermeiden.

Therapeutische Ansätze umfassen die Therapie mit Antikoagulantien, Throbozytenaggregationshemmer, Fibrinolyse, Thrombolyse, Haemodilution, Pentoxifyllin, Kortikosteroide, systemisches Acetazolamide, Makula-Gitter-, Scatter und panretinale Photokoagulation, sowie die Induzierung von chorioretinal-venösen Anatomosen mittels Photokoagulation.

Neue chirurgische therapeutische Ansätze sind die Adventitia Sheathotomie bei Astvenenverschluss (AVV) und die Radiäre Optikus-Neurotomie (RON) bei Zentralvenenverschluss (ZVV). Beide erscheinen viel versprechend, bedingen jedoch weitere klinische Prüfungen mit größeren Patientenanzahlen.

Summary

Retinal vein occlusion is a severe disease for which there is no therapy without potential risks. The natural course can potentially lead to blindness. The main aim of all therapeutic regimens is to maintain visual acuity and to reduce the risk of development of complications.

Non-surgical therapeutic options include anticoagulants and antiplatelet agents, fibrinolytic or thrombolytic agents, haemodilution, pentoxifyllin, photocoagulation, corticosteroids, systemic acetazolamide and laser-induced chorioretinal venous anastomosis.

The new surgical therapeutic options are Radial Optic Neurototny (RON) in central retinal vein occlusions, and Adventitial Sheathotomy in branch retinal vein occlusion. Both of these new therapies show great prospective, however further clinical investigation with larger study populations is needed.

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Authors and Affiliations

  1. Ludwig-Boltzmann-Institut für Retinologie und biomikroskopische Laserchirurgie, Juchgasse 25, A-1030, Wien

    T. Aggermann, S. Brunner & S. Binder

  2. Augenabteilung, Krankenanstalt Rudolfstiftung, Österreich

    S. Brunner & S. Binder

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  1. T. Aggermann
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  2. S. Brunner
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  3. S. Binder
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Correspondence to T. Aggermann.

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Aggermann, T., Brunner, S. & Binder, S. Therapien retinaler Venenverschlüsse — ein Überblick. Spektrum Augeheilkd 17, 200–205 (2003). https://doi.org/10.1007/BF03164392

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