Das Auge in der Inneren Medizin: Die diabetische Retinopathie

Diagnostik und Therapie der diabetischen Retinopathie haben in den zurückliegenden 15 Jahren riesige Fortschritte gemacht. Hochpräzise bildgebende Verfahren und die neu eingeführte pharmakologische Therapie mit direkt in das Auge verabreichten Wirkstoffen zur Hemmung des Vascular Endothelial Growth Factor (VEGF) oder Kortikosteroiden haben langjährige Standards geradezu revolutioniert. Die relevanten Aspekte erläutert dieser Beitrag.

Abstract

Diabetic retinopathy has seen tremendous progress in diagnostic tools and treatment in recent 15 years. Sight threatening stages like proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) can be treated much more effectively now. The recognition of vascular endothelial growth factor (VEGF) as a driver of proliferation and macular edema has led to the development of VEGF inhibiting drugs such as antibodies (Bevacizumab), fragments of an antibody (Ranibizumab), or a so called VEGF trap (Aflibercept). Laser treatment is no longer a gold standard. Today laser therapy is part of a combined treatment strategy. DME can be monitored quantitatively by ocular coherence tomography (OCT) measurements. For non-responders to VEGF inhibiting drugs, we have secondline corticosteroidal implants. However, screening examinations and early diagnosis of DME and PDR remain crucial. The same accounts for the collaboration of opthalmologists, general practioners, and diabetologists. Good control of diabetes and blood pressure is still important.

Schlüsselwörter

diabetische Retinopathie - Makulaödem - VEGF-Inhibitoren - Laser

Key words

diabetic retinopathy - macular edema - VEGF inhibitors - laser

Publication History

Article published online:
13 July 2021

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