Lasertherapie in der Augenheilkunde – ein Update

Zusammenfassung

Die retinale Photokoagulation stellt auch heute eine Therapieoption bei zahlreichen Netzhauterkrankungen dar. Dieser Beitrag soll die Frage klären, wann heute noch gelasert wird, und den Lesern einen Überblick über die typischen Indikationen und Therapiekonzepte der retinalen Photokoagulation geben sowie aktuelle Entwicklungen und Empfehlungen zusammenfassen.

Abstract

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. Retinal laser therapy is still widely used within retinal ophthalmology 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.

Kernaussagen

• 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.

• Das Anwendungsspektrum der retinalen Laserphotokoagulation ist vielfältig. Trotz und neben neuen, vielversprechenden medikamentösen Therapieansätzen stellt die retinale Laserbehandlung auch heute noch eine unverzichtbare Therapieoption dar, insbesondere

  • bei der proliferativen diabetischen Retinopathie,

  • bei venösen ischämischen Verschlüssen und

  • bei selteneren Erkrankungen wie Retinopathia praematurorum oder Morbus Coats dar.

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

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

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