Neovaskularisationsglaukome (NVG) gehören zu den im klinischen Alltag am häufigsten
anzutreffenden Sekundärglaukomen. Sie stellen ein schwerwiegendes Krankheitsbild dar,
das im
ungünstigsten Fall bis zu einer Enukleation führen kann. Dieser Beitrag gibt einen
Überblick über die Pathogenese, die häufigsten zugrunde liegenden Erkrankungen, die
erforderliche
Diagnostik und eine stadiengerechte Therapie.
Abstract
Neovascular glaucoma (NVG) is a severe potentially blinding disease, which represents
one of the most common types of secondary glaucomas. The majority of cases are caused
by ischemic
retinal conditions such as diabetic retinopathy, central retinal vein occlusion or
ocular ischemic syndrome. If appropriately diagnosed and treated, ideally the development
of NVG can be
prevented. Since treatment gets increasingly challenging as the disease progresses,
early diagnosis is of utmost importance. In this review pathogenesis, diagnosis, treatment
and prophylaxis
are discussed extensively. A focus is put on the consecutive stages through which
the disease progresses and how to diagnose and differentiate them. Ultimately a stage
adapted therapy
approach is detailed, consisting of the three blocks: 1. treatment of the underlying
disease/retinal ischemia, 2. adjunctive medical therapy (anti-VEGF) and 3. therapy
of the elevated
intraocular pressure.
Schlüsselwörter
Neovaskularisationsglaukom - Rubeosis iridis - Pathogenese - Diagnose - Therapie
Key words
Neovascular glaucoma - rubeosis iridis - pathogenesis - diagnosis - treatment