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Klin Monbl Augenheilkd 2012; 229(2): 126-134
DOI: 10.1055/s-0031-1299246
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Stellenwert der Scanning Laser Polarimetrie für die Glaukomdiagnostik

Clinical Value of Scanning Laser Polarimetry in Glaucoma Diagnostics
S. Kremmer
1   Augenklinik, Evangelisches Krankenhaus, Gelsenkirchen
2   Universitäts-Augenklinik Essen
,
G. Anastassiou
1   Augenklinik, Evangelisches Krankenhaus, Gelsenkirchen
2   Universitäts-Augenklinik Essen
,
J. M. Selbach
1   Augenklinik, Evangelisches Krankenhaus, Gelsenkirchen
2   Universitäts-Augenklinik Essen
› Author Affiliations
Further Information

Publication History

04 January 2012

16 January 2012

Publication Date:
14 February 2012 (online)

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Zusammenfassung

Unter dem Begriff Glaukom ist eine Vielzahl unterschiedlicher Erkrankungen zusammengefasst, die gemeinsam haben, dass die retinalen Ganglienzellen und ihre Axone geschädigt werden. Unbehandelt können sie im weiteren Verlauf der Apoptose unterliegen und abgebaut werden, was zu charakteristischen Schäden am Sehnervenkopf, Gesichtsfeldausfällen und im schlimmsten Fall bis zur Erblindung führen kann. Um einen Glaukomschaden zu verhindern, ist eine möglichst frühzeitige Entdeckung von Veränderungen der retinalen Ganglienzellen und ihrer Axone sowie deren Verlaufskontrolle von besonderer Bedeutung, um eine adäquate Behandlung einleiten und deren Wirksamkeit kontrollieren zu können. In den letzten Jahren hat sich die Scanning-Laser-Polarimetrie mit dem GDx (Carl Zeiss Meditec, Dublin, USA) zunehmend in der klinischen Untersuchung der Nervenfaserschicht bei Glaukom etablieren können. Zum heutigen Zeitpunkt hat das GDx mit seiner hohen Auflösung, dem großen Komfort für Patienten und Untersucher und seinen gut reproduzierbaren Ergebnissen eine Schlüsselrolle in der aktuellen Glaukomdiagnostik. Insbesondere bei sonst schwer beurteilbaren Papillen (z. B. Mikro- oder Makropapillen), schrägem Sehnerveneintritt und Papillenanomalien (z. B. Drusenpapillen) bietet die moderne Nervenfaserdiagnostik mithilfe des GDx im klinischen Alltag eine wesentliche Bereicherung.

Abstract

The term glaucoma is used as a melting pot of many different diseases which have in common that the retinal ganglion cells and their axons are damaged. Untreated, apoptosis can be induced causing ganglion cell death which subsequently leads to typical glaucomatous damage at the optic nerve head, scotomas of the visual fields, and in the worst case scenario to blindness. It is well known that patients with glaucoma can suffer a 20 to 50 % loss of retinal ganglion cells before a defect becomes evident in standard white on white perimetry. To prevent glaucomatous damage, it is important to detect changes of the retinal ganglion cells and their nerve fibre layer as early as possible and to monitor their follow-up as closely as possible in order to find an adequate treatment of glaucoma, and to control its efficiency. In the past few years, scanning laser polarimetry by means of GDx technology (Carl Zeiss Meditec, Dublin, USA) could be established as a new method to measure the retinal nerve fibre layer not only qualitatively but even quantitatively. Presently, the GDx plays an important role in actual glaucoma diagnostics on account of its high resolution, the comfort for both patient and user, and its highly reproducible measurements. Especially in difficult evaluable optic nerve heads (e. g., micro- and macrodiscs), tilted discs, and optic disc anomalies (e. g., optic nerve drusen) modern nerve fibre diagnostics by means of GDx technology is a helpful enrichment in clinical routine.

Schlüsselwörter

Glaukom - Nervenfaserdiagnostik - Scanning-Laser-Polarimetrie - GDx

Key words

glaucoma - nerve fibre diagnostics - scanning laser polarimetry - GDx
 

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