Chirurgie der altersbedingten Makuladegeneration – Ist das im Zeitalter der Pharmakotherapie noch eine Option?

Zusammenfassung

Diese Übersicht befasst sich mit der Relevanz der chirurgischen Therapie der altersbedingten Makuladegeneration (AMD) vor dem Hintergrund der Pathophysiologie der AMD und der aktuellen pharmakologischen Therapiemöglichkeiten. Diskutiert werden die unterschiedlichen chirurgischen Möglichkeiten wie die subretinale Membranexzision, die Transplantation von Iris- und retinalen Pigmentepithelzellen, die Transplantation von Aderhaut und Pigmentepithel (PATCH) und die Translokationsverfahren. Die Entfernung epiretinaler Membranen vor dem Hintergrund einer Drusenmakulopathie sowie die Vitrektomie vor epimakulärer Brachytherapie sind die abschließenden Themen. Während insgesamt die pharmakologische Therapie die chirurgischen Verfahren weitgehend abgelöst hat, bleiben chirurgische Verfahren immer noch für Einzelfälle eine relevante Option und müssen daher im Armamentarium des Netzhautchirurgen erhalten bleiben.

Abstract

This review assesses the relevance of surgical approaches for age-related macular degeneration (AMD) with respect to the pathophysiology of AMD and the current pharmacological possibilities. We discuss the different surgical approaches such as subretinal membrane excision, cell transplantation (IPE and RPE) and transplantation of retina and choroid (PATCH), as well as translocation surgery. Peeling of epiretinal membranes in patients with drusen as well as vitrectomy before epiretinal brachytherapy (VIDEON system) are the final topics. While overall pharmacotherapy has displaced surgical approaches, surgery is worthy of consideration in selected cases. For these patients surgical options need to be maintained in the armamentarium of retinal surgeons.

Schlüsselwörter

altersbedingte Makuladegeneration - chirurgische Verfahren - Retina - Chorioidea

Key words

age-related macular degeneration - surgical options - retina - choroid

• Literatur


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