Wann wird heute noch gelasert?

Zusammenfassung

Hintergrund Die Laserbehandlung ist eine Therapieoption bei retinalen, bevorzugt vaskulären Pathologien. Meist kommen destruktive Verfahren zum Einsatz. Durch das Hinzukommen der intravitrealen Applikation von Antikörper(fragmenten) gegen den Wachstumsfaktor „vascular endothelial growth factor“ (VEGF) muss jedoch bei einigen Indikationen der Einsatz der Laserbehandlung als First-Line-Therapie kritisch hinterfragt werden. Neue Strategien und Behandlungskonzepte sollen erläutert werden.

Material und Methoden Zusammenfassung der Literatur aus PubMed sowie relevanter Leitlinien und Stellungnahmen.

Ergebnisse und Schlussfolgerung Das Anwendungsspektrum der retinalen Laserphotokoagulation ist vielfältig. Trotz und neben neuen, vielversprechenden medikamentösen Therapieansätzen stellt die retinale Laserbehandlung auch heute noch eine unverzichtbare Therapieoption insbesondere bei der proliferativen diabetischen Retinopathie, venösen ischämischen Verschlüssen und selteneren Erkrankungen wie Retinopathia praematurorum oder Morbus Coats dar.

Abstract

Background Laser therapy is an important treatment option in retinal diseases, especially in cases of vascular involvement. Most approaches are based on coagulation of retinal structures. As there is increasing use of agents targetting vascular endothelial growth factor in the treatment of macular diseases, indications for the use of laser treatment need to be reviewed carefully, especially with respect to their significance in first line therapy. This article explains recent strategies and treatment protocols.

Materials and Methods Review of current literature in PubMed as well as synopsis of relevant guidelines.

Results and Conclusion Retinal laser therapy is still widely used within retinal opthalmology and covers a large spectrum of indications. Despite the success of medical approaches, retinal laser therapy remains an indispensable treatment option for proliferative diabetic retinopathy, central or peripheral vein occlusion and less frequent pathologies, such as retinopathy of prematurity or Coatsʼs disease.

Schlüsselwörter

Laserkoagulation - proliferative diabetische Retinopathie - Zentralvenenverschluss - navigierte Lasertechnologie - Mikropulsdiodenlaser - Retinopathia praematurorum

Key words

laser coagulation - proliferative diabetic retinopathy - central vein occlusion - navigated laser technology - micropulse diode laser - retinopathy of prematurity

^* P. Enders und F. Schaub haben die gemeinsame Erstautorenschaft.

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