Diabetische Makulopathie

Der Ophthalmologe (Impact Factor: 0.53). 01/2010; 107(8):773-788. DOI: 10.1007/s00347-010-2202-z

ABSTRACT Trotz medikamentöser Fortschritte und teurer Präventionsprogramme steigt die Prävalenz der diabetischen Retinopathie, einer
der häufigsten Erblindungsursachen in Deutschland, aufgrund des demografischen Wandels weiter an. Nach wissenschaftlichem
Stand ist die „focal/grid“-Laserkoagulation, in Kombination mit der intravitrealen operativen Medikamentenapplikation (IVOM)
von VEGF-Inhibitoren (VEGF: „vascular endothelial growth factor“), zurzeit die wirksamste Therapie des klinisch signifikanten
Makulaödems mit Foveabeteiligung. Vitreomakuläre Interface-Anomalien erfordern den Einsatz der modernen Netzhautchirurgie.
Für die ischämische Makulopathie gibt es keine effektive Behandlung. Die zeitgemäße Einstellung des Blutzuckerspiegels und
die optimale Kontrolle relevanter Risikofaktoren haben in der interdisziplinären Abstimmung einen festen Stellenwert. Innovative
Entwicklungen in der pharmakologischen Therapie eröffnen eine optimistische Perspektive auf mögliche Funktionsverbesserungen,
die die Lebensqualität der Diabetespatienten steigern werden.

Due to demographic change the incidence of diabetic retinopathy has risen in spite of new facilities and prevention campaigns
and is still one of the leading causes of blindness in Germany. The combination of focal/grid laser photocoagulation and an
intravitreal anti-VEGF (vascular endothelial growth factor) regimen is the first line approach for clinically significant
macular edema with foveal involvement and is evidence-based. Vitreomacular interface abnormalities can be effectively treated
by modern vitreomacular surgery. Unfortunately, no proven treatment modality can be provided for ischemic maculopathy. The
management of systemic risks factors, such as hyperglycemia and arterial hypertension, remains a task of great importance
despite all modifications and increase of knowledge during recent years. Innovative developments in the field of intravitreal
pharmacotherapy have opened up new vistas. There are good prospects that modern ophthalmology will not be limited to preserving
visual function but to allow improvements and consequently enhance health-related quality of life for diabetic patients.

SchlüsselwörterDiabetische Makulopathie-Makulaödem-Laserkoagulation-Anti-VEGF-Therapie-HbA1c (Glykohämoglobin)
KeywordsDiabetic retinopathy-Macula edema-Laser photocoagulation-Anti-VEGF therapy-HbA1c (glycohemoglobin)

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