OCT der RNFL zur Glaukomdiagnose – Goldstandard oder nur ein Teil des Puzzles?

Zusammenfassung

Bei Vorliegen eines Glaukoms sind eine frühzeitige Diagnose und eine genaue Überwachung unerlässlich, um die Krankheit wirksam zu behandeln und einen weiteren irreversiblen Verlust retinaler Ganglienzellen zu vermeiden. Da es sich beim Glaukom um eine komplexe Erkrankung handelt, die i. d. R. zunächst asymptomatisch verläuft, sind regelmäßige klinische und bildgebende Untersuchungen von großer Bedeutung. Als einfach durchzuführende und reproduzierbare Diagnostik hat sich in den letzten Jahren die Darstellung der retinalen Nervenfaserschicht (RNFL) mithilfe der SD-OCT (Spectral-Domain Optical Coherence Tomography) etabliert. Diese Bildgebungstechnik ermöglicht eine präzise Analyse der RNFL und ermöglicht eine Überwachung der retinalen Nervenfaserdicke. In diesem Artikel sollen daher die anatomischen Grundlagen, die zu erwartenden Veränderungen der RNFL beim Vorliegen eines Glaukoms im Vergleich zu einer unauffälligen Kontrollaufnahme und die Möglichkeiten zur Progressionsanalyse diskutiert werden. Darüber hinaus werden die Limitationen der Methode aufgezeigt und zur Verfügung stehende ergänzende OCT-Aufnahmen angesprochen. Die Kenntnis von möglichen Fehlerquellen erleichtert eine korrekte Analyse der RNFL-Scans. Tipps für die Interpretation von RNFL-Scans sollen helfen, die zur Verfügung stehenden Daten effektiv zu nutzen und fundierte Entscheidungen über die Behandlung und das Management von Glaukompatienten zu treffen.

Schlüsselwörter

Glaukom - OCT - RNFL - Diagnose - Progression

Publication History

Received: 25 October 2024

Accepted: 05 December 2024

Article published online:
24 July 2025

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