Die Frühgeborenenretinopathie

Zusammenfassung

Dieser Übersichtsartikel fasst den aktuellen Stand des Wissens über die Frühgeborenenretinopathie (Retinopathia praematurorum, RPM) zusammen. Kenntnisse über dieses meist bei extrem unreifen Säuglingen auftretende Krankheitsbild sind weiterhin wichtig, da trotz verbesserter neonatologischer Intensivmedizin die RPM auch in Zukunft auftritt, aber durch augenärztliche Screeninguntersuchungen und ggf. durch eine Therapie zum optimalen Zeitpunkt das Erblindungsrisiko deutlich reduziert werden kann. Es werden die historische Entwicklung der RPM kurz dargestellt sowie die neuesten Erkenntnisse der Pathophysiologie beschrieben. Die Ergebnisse der großen multizentrischen Therapiestudien werden zusammengefasst. Die aktuelle deutsche Leitlinie zur Screeninguntersuchung wird erläutert und mit den Empfehlungen anderer Länder verglichen. Die verschiedenen Therapiemöglichkeiten und Behandlungsergebnisse werden diskutiert, derzeit ist die indirekte Laserkoagulation im therapiebedürftigen Stadium die Therapie der Wahl. Die ophthalmologischen Spätveränderungen bei ehemaligen Frühgeborenen werden erwähnt. Am Ende folgt ein Ausblick auf mögliche zukünftige Behandlungsmethoden wie z. B. der Einsatz von antiangiogenen Faktoren.

Abstract

This review summarizes the knowledge and highlights recent advances in clinical research of retinopathy of prematurity (ROP). This disease is still important, because improvements in neonatal intensive care during the last years have increased the survival of the most immature newborns, but did not diminish the ROP frequency. Ophthalmologic screening and, if applicable, laser treatment at the optimal time for advanced ROP prevents blindness in most cases. The history, classification and the modern concepts of ROP pathophysiology are described. The results of various multicenter treatment trials are summarized. The current German screening guidelines are discussed with the guidelines of other nations. The therapeutic treatment strategies and the treatment results are discussed. The ophthalmologic disorders of former preterm infants, as higher rates of amblyopia, strabismus, and refractive error, are mentioned. Possible future therapies, e. g. anti-angiogenic factors are discussed.

Schlüsselwörter

Frühgeborenenretinopathie - RPM - Retinopathia praematurorum - RPM-Screening-Kriterien - Laserkoagulation

Key words

Retinopathy of prematurity - ROP - laser treatment

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