Ultraweitwinkel-Fundusfotografie und -angiografie in der Differenzialdiagnose und zur Therapieplanung bei peripheren vaskulären Netzhauterkrankungen

Zusammenfassung

Bei vaskulären Erkrankungen der Netzhautperipherie ist eine Bildgebung, die einen umfassenden Einblick in die periphere Netzhaut ermöglicht und diese reproduzierbar abbilden kann, von hoher klinischer Relevanz. Die Weitwinkelangiografie ist in der Differenzialdiagnose peripherer vaskulärer Netzhauterkrankungen insbesondere zur Therapieentscheidung und Verlaufsbeurteilung wertvoll. Da Erkrankungen wie Morbus Coats und die familiär exsudative Vitreoretinopathie meist innerhalb der 1. oder Anfang der 2. Lebensdekade diagnostiziert werden, ist bei den meisten Patienten mit unzureichender Compliance bei Fundusaufnahmen zu rechnen. Gerade hier ermöglicht die Ultraweitwinkelbildgebung eine deutlich kürzere Aufnahmezeit im Vergleich zu Kompositaufnahmen. Dennoch können auch die aktuellsten Systeme nicht die gesamte Netzhaut vollständig abbilden. Der Bildausschnitt muss daher gezielt durch Blickrichtungen zum betroffenen Areal gelenkt werden und dem Fotografen die klinische Fragestellung stets zu Beginn der Aufnahmen bewusst sein. Daher steht nach wie vor eine gründliche Funduskopie in Mydriasis durch den erfahrenen Augenarzt an erster Stelle.

Abstract

Investigation of vascular diseases of the peripheral retina requires imaging procedures that allow a comprehensive view of the periphery, as well as reproducible pictures. In particular, ultra-wide field fluorescence angiography facilitates diagnosis, therapeutic decisions and follow-up examinations. While vasculopathies such as Coats disease and familiar exudative vitreoretinopathy are diagnosed within the first and second decade of life, patientsʼ compliance during fundus imaging is typically reduced within this age range. Compared to the repeated imaging procedures for composite formation, ultra-wide field imaging has significantly reduced recording time. Nevertheless, current imaging systems are not able to map the entire retina in scaled proportions. Therefore, the imaging frame must be guided by patientsʼ gaze onto the affected retinal area. Moreover, the medical photographer must be aware of the clinical setting and the region of interest. Hence, previous detailed funduscopy by trained ophthalmologists will remain indispensable.

Schlüsselwörter

familiär exsudative Vitreoretinopathie - Hämangioblastom - Morbus Coats - vasoproliferative retinale Tumoren - Weitwinkelangiografie - Weitwinkelbildgebung

Key words

familiar exudative vitreoretinopathy - hemangioblastoma - coats disease - vasoproliferative retinal tumor - ultra-wide field angiography - ultra-wide field imaging

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