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Papillenfotografie und retinale Nervenfaserschichtfotografie

Optic disc photography and retinal nerve fiber layer photography

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Zusammenfassung

Neben der Papillenbeurteilung an der Spaltlampe und der Anwendung von laserbasierten High-Tech-Verfahren ist die stereoskopische Papillenfotografie weltweit verbreitet, um glaukomatöse Papillenveränderungen zu dokumentieren. Vorteile der Stereofotografie sind die permanente Papillendokumentation, gute Darstellbarkeit auch der peripapillären Region sowie für den Patienten eine – zumindest bei Anwendung nicht mydriatischer Funduskameras – schnelle und wenig unangenehme Untersuchung. Nachteile sind die Abhängigkeit von klaren Medien, die mögliche Pupillenerweiterung, das Vorhandensein eines erfahrenen Fotografen und der Zeitverzug.

Das Verfahren der retinale Nervenfaserschichtfotografie (RNFL-Fotografie) basiert auf der Absorption von grünem Licht durch Melanin in der RNFL. Im Vergleich zu laserbasierten Verfahren ist die RNFL-Technik aufwendig und erfordert eine sehr weite Pupille und viel Erfahrung des Fotografen. Die Beurteilung durch den Untersucher erfordert ebenfalls viel Erfahrung und zeigt eine gewisse Lernkurve. Mittels RNFL-Fotos lässt sich ein Glaukomschaden vor Auftreten eines Gesichtsfelddefekts erkennen.

Abstract

In addition to optic disc assessment at the slit lamp and the use of imaging devices for glaucoma diagnosis, optic disc photography is widely used in clinical practice. The advantages of stereophotography are a permanent recording of the optic disc status especially used for serial evaluation of discs, good visibility of the peripapillary region and a relatively fast examination without pupil dilation (if using non-mydriatic fundus cameras). The limitations are the need for clear media, pupil dilation, a skilled photographer and the delay involved.

Retinal nerve fiber layer (RNFL) photography is based on the absorption of green light by melanin in the retinal nerve fiber layer. In comparison to scanning laser devices this methodology is not as convenient and requires widely dilated pupils and high levels of competence by technical personnel. Furthermore, the examination with RNFL photographs requires considerable learning and experience. RNFL photography detects glaucoma damage before visual field defects occur.

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  1. Universitäts-Augenklinik Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    E.M. Hoffmann

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Hoffmann, E. Papillenfotografie und retinale Nervenfaserschichtfotografie. Ophthalmologe 106, 683–686 (2009). https://doi.org/10.1007/s00347-009-1997-y

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