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Koagulationstherapie bei Frühgeborenenretinopathie

Vergleich der anatomischen und funktionellen Ergebnisse nach Laser- oder Kryokoagulation

Comparison of the anatomical and functional outcome after laser or cryotherapy for retinopathy of prematurity (ROP)

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Zusammenfassung

Ziel

Vergleich der anatomischen und funktionellen Ergebnisse nach einer Laser- oder Kryokoagulationsbehandlung aufgrund einer Frühgeborenenretinopathie.

Patienten und Methode

Zwischen April 1991 und Februar 2002 wurden 127 Augen (65 Säuglinge) nach Erreichen der Schwellenkriterien zur Behandlung entweder kryo- (46 Augen bis März 1993) oder laserkoaguliert (81 Augen). Zusätzlich wurden 10 Augen (5 Säuglinge) mit einer Vaskularisationsgrenze in der Zone I bereits zum Zeitpunkt von „prethreshold“ laserkoaguliert.

Ergebnisse

Ein „unfavorable outcome“, entsprechend der Cryo-ROP-Studie, bestand bei 1/91 (1%) laser- und 3/46 (6,5%) kryokoagulierten Augen. Eine Gefäßwinkelverengung bzw. eine Makulaverlagerung wurde bei 6/91 (6,6%) der laser- und in 7/46 (15,2%) der kryokoagulierten Augen beobachtet. Ein Visus von mindestens 0,8 wurde bei den laserkoagulierten Augen signifikant häufiger erreicht (39,2% in der Lasergruppe, 17,6% in der Kryogruppe).

Schlussfolgerung

Durch eine rechtzeitige Koagulation nach Erreichen der Schwellenkriterien zur Behandlung kann ein sehr gutes anatomisches und funktionelles Ergebnis erzielt werden. Die Resultate nach Laserkoagulation sind denen nach Kryokoagulation überlegen, sodass die Laserkoagulation die Therapie der Wahl ist.

Abstract

Purpose

To analyze and compare the anatomical and functional outcome following cryotherapy or laser therapy for ROP.

Methods

Between April 1991 and February 2002, 127 eyes with ROP (65 patients) were treated after threshold ROP was reached. Ten additional eyes with zone I disease were treated with prethreshold. All patients were followed up until a stable retinal situation occurred.

Results

An “unfavorable outcome,” as described in the Cryo ROP study, occurred in 1 of 91 (1%) eyes with laser treatment and in 3 of 46 (6.5%) eyes with cryotherapy. Temporal dragging of vessels was noticed in 6 of 91 eyes (6.6%) with laser treatment vs 7 of 46 eyes (15.2%) with cryotherapy, respectively. Visual acuity ≥20/25 was achieved in 39.2% in eyes with laser therapy and in 17.6% with cryotherapy (p<0.05).

Conclusion

A strict screening protocol and treatment at onset of threshold disease results in an excellent anatomical and functional outcome. The results of laser therapy were superior over cryotherapy, indicating that laser treatment is the therapy of choice.

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Authors and Affiliations

  1. Universitätsaugenklinik, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin

    C. Jandeck, H. Heimann & M. H. Foerster

  2. Retina Science, Bonn

    U. Kellner

  3. Universitätsaugenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, 12200 , Berlin

    C. Jandeck

Authors
  1. C. Jandeck
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  2. U. Kellner
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  3. H. Heimann
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  4. M. H. Foerster
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Corresponding author

Correspondence to C. Jandeck.

Additional information

Als Vortrag gehalten auf der 101. Tagung der Deutschen Ophthalmologischen Gesellschaft in Berlin 2003.

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Jandeck, C., Kellner, U., Heimann, H. et al. Koagulationstherapie bei Frühgeborenenretinopathie. Ophthalmologe 102, 33–38 (2005). https://doi.org/10.1007/s00347-004-1049-6

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  • DOI: https://doi.org/10.1007/s00347-004-1049-6

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