Retinale angiomatöse Proliferationen mit assoziierter Pigmentepithelabhebung

Lommatzsch, Albrecht; Heimes, B.; Gutfleisch, Matthias; Spital, Georg; Dietzel, Martha; Pauleikhoff, Daniel

doi:10.1007/s00347-010-2221-9

Ophthalmologe

2010

DOI: 10.1007/s00347-010-2221-9

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Retinale angiomatöse Proliferationen mit assoziierter Pigmentepithelabhebung

Albrecht Lommatzsch

B. Heimes²,

Matthias Gutfleisch³

et al.

Abstract: The morphological functional results can be improved in the early months using the therapy strategy presently recommended in Germany. However, in later stages there was a significant worsening of the functional results. Modification of the treatment strategy with respect to close surveillance and possibly early stage repeat treatment would seem advisable.

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Cited by 6 publications

References 34 publications

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Pigmentepithelabhebung bei exsudativer Makuladegeneration

Lommatzsch

2010

Ophthalmologe

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Vascularized pigment epithelial detachment (PE detachment) can be viewed as a special form of occult choroidal neovascularization (CNV) owing to the natural course of the disease, its specific pathogenesis and its response to various forms of treatment. This applies to serous PE detachment associated with both occult CNV and also with retinal angiomatous proliferation (RAP). A tear in the retinal pigment epithelium (RIP) represents a serious complication of vascularized PE detachment and is often associated with acute vision deterioration that not uncommonly also involves massive subretinal hemorrhaging. The pathomechanism underlying the development of RIP has not yet been completely elucidated. The notion that the PED bursts as a result of the increased pressure stands in contrast to the theory that the CNV contracts and causes scarring which in turn causing secondary RIP. Anti-VEGF therapy is currently the preferred treatment. However, the initial stabilization of visual acuity after treatment could not be confirmed in long-term studies and after 2 years visual acuity deteriorated significantly. Furthermore, optimal VEGF treatment regimens have also not been defined and the criteria for repeated treatment have not been established as yet. Presently, visual deterioration and the presence of subretinal and intraretinal exudates seem to indicate that treatment will be effective. Here, high resolution OCT imaging should help to provide further insight into the matter.

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Pigmentepithelabhebung bei exsudativer Makuladegeneration

Lommatzsch

2010

Ophthalmologe

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Therapie der retinalen angiomatösen Proliferation im Stadium III

et al. 2012

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Retinal angiomatous proliferation (RAP) is a subtype of exudative age-related macular degeneration which is characterized by an intraretinal origin of the lesion and a particularly poor prognosis. In this retrospective case study 33 eyes from 33 patients with stage III RAP lesions were included and initially treated with 3 intravitreal injections of 0.5 mg ranibizumab at monthly intervals. Criteria for extended treatment were visual deterioration, fresh bleeding, residual fluid or increase of the central retinal thickness in optical coherence tomography (OCT) as well as persisting activity in fluorescence angiography (FLA). The follow-up period was 8 months. The mean best corrected visual acuity (BCVA) increased insignificantly from logMAR 0.71 at the start of therapy to logMAR 0.67 after the first 3 intravitreal treatment injections and remained stable up to 8 months. The mean decrease of the central retinal thickness after 4 months (-90 µm) and after 8 months (-70 µm) was significant. Of the patients included in the study 67 % were treated repeatedly and the mean frequency of reinjections was 2.27 injections after 8 months. The intravitreal injection of ranibizumab in patients with stage III RAP lesions resulted in functional and anatomical stabilization. In most cases repeated treatment is necessary which underlines the urgent need for close surveillance in follow-up.

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Seröse vaskularisierte Pigmentepithelabhebungen bei exsudativer altersbedingter Makuladegeneration

et al. 2014

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Retinale angiomatöse Proliferationen mit assoziierter Pigmentepithelabhebung

Cited by 6 publications

References 34 publications

Pigmentepithelabhebung bei exsudativer Makuladegeneration

Pigmentepithelabhebung bei exsudativer Makuladegeneration

Therapie der retinalen angiomatösen Proliferation im Stadium III

Seröse vaskularisierte Pigmentepithelabhebungen bei exsudativer altersbedingter Makuladegeneration

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