Intravitreale Medikamenteneingabe bei retinalem Venenverschluss – pathophysiologische Mechanismen und angewandte Substanzen

Zusammenfassung

Die intravitreale Medikamenteninjektion ist innerhalb weniger Jahre ein fester Bestandteil in der Behandlung des retinalen Venenverschlusses geworden. Bei den verwendeten Substanzen, von denen mittlerweile mehrere in großen randomisierten Studien getestet wurden, handelt es sich um Kortikosteroide einerseits und Inhibitoren des vaskulären endothelialen Gefäßwachstumsfaktors VEGF andererseits. Die Behandlungserfolge, die sich mit den meisten dieser Medikamente erzielen lassen, haben auch zu neuen Erkenntnissen der pathophysiologischen Vorgänge geführt. In dem vorliegenden Übersichtsartikel werden die aktuellen Substanzen und ihre Wirkungsweise diskutiert, die Daten der klinischen Studien kritisch evaluiert und die neue Therapieoption der intravitrealen Medikamenteneingabe in das bisher etablierte Behandlungsschema des retinalen Venenverschlusses eingefügt.

Abstract

The novel therapeutic principle of intravitreal drug therapy for retinal vein occlusion has become an integrated constituent of clinical practice over the last years. The two substance classes that have been evaluated in large randomised clinical trials so far are corticosteroids and inhibitors of vascular endothelial growth factor (VEGF). The reported treatment success of these intravitreally administered substances has lead not only to a paradigm shift in clinical care but has also advanced our understanding of the underlying pathophysiological principles of retinal vein occlusions. In this review the different substances are discussed, their mechanisms of action are analysed and the results of the large clinical trials available to date are critically evaluated. Furthermore, an approach to integrate these novel treatment options into the exisitng treatment regimes for retinal vein occlusions is suggested.

Schlüsselwörter

Retina - Pathologie - Glaskörper - intravitreale Injektion

Key words

retina - pathology - vitreous - intravitreal injection

Literatur

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