Retinale angiomatöse Proliferationen

Zusammenfassung

Retinale angiomatöse Proliferationen, synonym Typ-3-Neovaskularisationen, sind eine relativ häufige Manifestation bei Patienten mit exsudativer altersbedingter Makuladegeneration. Ihre Prävalenz bei diesen Patienten wird hierbei auf 12–15 % geschätzt. Bestimmte funduskopische Zeichen wie extrafoveale, intraretinale Blutungen, ein umschriebenes zystoides Makulaödem oder auch eine Verbindung der Läsion zu der retinalen Gefäßzirkulation weisen auf RAP-Läsionen hin. Die funduskopische Verdachtsdiagnose lässt sich am besten mittels ICG-Angiografie sichern, jedoch gewinnt auch die OCT-Bildgebung zunehmend an Bedeutung. Interessanterweise weisen RAP-Läsionen Besonderheiten sowohl bei der Demografie als auch in ihrem Therapieansprechen auf, die sie von Typ-1- und Typ-2-Neovaskularisationen unterscheiden. Die aktuelle Therapie der Wahl stellt der Einsatz von VEGF-Inhibitoren dar. Doch gerade Kombinationstherapien, bei denen zum Beispiel Anti-VEGF-Inhibitoren mit der photodynamischen Therapie kombiniert werden, stehen derzeit im Fokus der Wissenschaft.

Abstract

Retinal angiomatous proliferations, also known as type 3 neovascularisation, are a common entity amongst patients with age-related macular degeneration. Their prevalence is being estimated at around 12–15 % in this group of patients. Certain funduscopic signs like an extravofeal, intraretinal haemorrhage, cystoid macular oedema or a retinal anastomosis of the lesion are considered to be pathognomonic. Verification of the diagnosis should be based on ICG angiography, although OCT is gaining popularity. Interestingly, RAP lesions seem to have distinctive demographic characteristics and respond differently to established therapies, differentiating them from regular type 1 or type 2 neovascularisation. Current therapies of choice are VEGF inhibitors. Nonetheless, combination therapies, combining different approaches like anti-VEGF treatment and photodynamic therapy, have received more attention recently.

Schlüsselwörter

retinale angiomatöse Proliferation - RAP - AMD - VEGF - PDT

Key words

retinal angiomatous proliferation - RAP - AMD - VEGF - PDT

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