Zusammenfassung
Die akute Retinanekrose (ARN) ist ein seltenes Krankheitsbild, das durch Herpesviren
ausgelöst wird. Immunsupprimierter Status und durch die akute Retinanekrose ausgelöste
Komplikationen führen in vielen Fällen zu einem schlechten visuellen Endergebnis.
Eine frühe Diagnosestellung durch Polymerasekettenreaktion und Antikörperbestimmungen
aus Vorderkammer- und Glaskörperpunktat wird daher empfohlen. Hierdurch kann einerseits
das therapeutische Management verbessert sowie andererseits eine Krankheitsprogression
mit erhöhtem Komplikationsrisiko vermindert werden. Gute Therapieerfolge sind durch
antivirale Kombinationstherapien mit Aciclovir, Foscarnet und Ganciclovir in systemischer
und intravitrealer Form möglich. Literatur-Empfehlungen und eigene Erfahrungen werden
dargestellt.
Abstract
Acute retinal necrosis (ARN) is a rare entity caused by Herpes viruses. An immunocompromised
background and the complications of ARN mostly lead to a poor visual outcome. Confirmation
of the early diagnosis through polymerase chain reaction and antibody detection from
aqueous or vitreous taps is recommended to improve the medical management and prevent
disease progression with an increased risk of complications. Favourable outcomes are
possible by means of combined antiviral systemic and intravitreal strategies with
Acyclovir, Foscarnet and Ganciclovir. We report on the relevant literature recommendations
and our own experience.
Schlüsselwörter
akute Retinanekrose - Polymerasekettenreaktion - Goldmann-Witmer-Koeffizient - antivirale
Therapie - intravitreale Injektion - Vitrektomie
Key words
acute retinal necrosis - polymerase chain reaction - Goldman-Witmer coefficient -
antiviral therapy - intravitreal injection - vitrectomy
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Dr. S. Winterhalter
Augenklinik, Universitätsklinikum Düsseldorf
Moorenstr. 5
40225 Düsseldorf
Phone: ++49/2 11/8 11 73 20
Fax: ++49/2 11/8 11 95 57
Email: billewin@gmx.de
