Zusammenfassung
Seit der Einführung der vitreoretinalen Chirurgie vor über 40 Jahren gab es zunächst stetig Bestrebungen, toxische Effekte, die z. B. durch Spüllösungen, Endoillumination oder mechanische Manipulation entstehen können, zu reduzieren. In letzter Zeit gibt es auch Versuche, neurodegenerative Prozesse am Auge durch pharmakologische Intervention zu verhindern. Als ein Beispiel eines solchen neuroprotektiven Ansatzes kann die Verwendung von Taurin als Zusatzstoff in Spüllösungen angesehen werden. Der Einsatz von therapeutischen Substanzen im Rahmen der vitreoretinalen Chirurgie bedeutet hinsichtlich der klinischen Zulassung einen erhöhten Aufwand an präklinischer Testung und klinischen Studien. Derzeit werden praktisch keine Neuroprotektiva im Rahmen vitreoretinaler Chirurgie routinemäßig eingesetzt. Experimentelle Studien deuten jedoch auf ein hohes Potenzial verschiedenster neuroprotektiver Substanzen hin. Der nachfolgende Beitrag soll einen Überblick über aktuelle neuroprotektive Ansätze mit potenzieller Anwendbarkeit in der vitreoretinalen Chirurgie geben und deren klinische Eignung kritisch diskutieren.
Abstract
After introduction of vitreoretinal surgery more than 40 years ago, further development of the procedure involved a continuous reduction of potential toxic effects by irrigating solutions, endoillumination or mechanical manipulation. Recently, additional efforts were made to prevent neurodegeneration via pharmacological intervention. Taurine as additive for irrigating solutions can be considered as an example for neuroprotectants in vitreoretinal surgery. Approval of neuroprotective agents demands an increased effort for preclinical and clinical evaluation. To date, only few neuroprotective substances are used in clinical routine in the context of vitreoretinal surgery, however, experimental data suggest a high potential of various neuroprotective agents. The following article gives an overview of current neuroprotective approaches feasible for vitreoretinal surgery and a critical analysis of their clinical relevance.
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Interessenkonflikt. S. Thaler, C. Haritoglou und F. Schuettauf geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Thaler, S., Haritoglou, C. & Schuettauf, F. Neuroprotektive Ansätze. Ophthalmologe 110, 941–947 (2013). https://doi.org/10.1007/s00347-013-2831-0
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DOI: https://doi.org/10.1007/s00347-013-2831-0