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Chirurgische Therapie retinaler Venenverschlüsse

Surgical treatments for retinal vein occlusion

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Zusammenfassung

Das therapeutische Spektrum zur Behandlung von Venenverschlüssen ist durch die chirurgischen Verfahren radiäre Optikoneurotomie (RON) und retinale endovasale Lyse (REVL) beim Zentralvenenverschluss und arteriovenöse Dissektion (AVD) beim Venenastverschluss deutlich erweitert worden. Zu keinem dieser Verfahren liegen aber bisher Daten vor, die den heutigen Ansprüchen einer evidenzbasierten Medizin genügen. Es ist deshalb schwierig, den tatsächlichen Stellenwert der einzelnen Verfahren zu beurteilen und ihnen die passende Indikation zuzuweisen. Dies wird durch die neuen und viel versprechenden Erfolge der intravitreal injizierten Medikamente (z. B. Steroide und antiangiogenetische Substanzen) nochmals erschwert. In diesem Artikel sollen die unterschiedlichen chirurgischen Verfahren vorgestellt und deren bisherige Ergebnisse diskutiert werden.

Abstract

The range of therapeutic options for the treatment of retinal vein occlusions has been decisively extended by three new surgical methods: radial optic neurotomy (RON) and retinal endovascular lysis (REVL) for central retinal vein occlusion, and arteriovenous dissection (AVD/sheathotomy) for branch retinal vein occlusion. None of those methods has been tested in randomised studies meeting the requirements of evidence-based medicine. It is therefore difficult to assess the relative values of the individual procedures and determine in what precise circumstances each is indicated. The difficulties are compounded further by the use of these techniques in association with new and promising intravitreally injected drugs (e.g. steroids and angioinhibitors), which makes it even more difficult to assess the real efficacy of the surgical methods. In this paper we discuss the three different surgical methods and try to evaluate their clinical benefit.

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  1. Universitätsaugenklinik, Killianstraße 5, 79106, Freiburg, Deutschland

    N. Feltgen, H. Agostini & L. Hansen

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  1. N. Feltgen
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  2. H. Agostini
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  3. L. Hansen
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Correspondence to N. Feltgen.

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Feltgen, N., Agostini, H. & Hansen, L. Chirurgische Therapie retinaler Venenverschlüsse. Ophthalmologe 104, 279–284 (2007). https://doi.org/10.1007/s00347-007-1508-y

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