Okuläre Malformation und Netzhautablösung im Kindesalter

Zusammenfassung

Verschiedene Malformationen des hinteren Augenabschnitts, insbesondere Fehlbildungen des N. opticus, ein Kolobom und ein persistierender hyperplastischer primärer Vitreus (PHPV), sind mit einem hohen Risiko assoziiert, dass sich bereits im Kindes- und Jugendalter eine Netzhautablösung ausbildet. Bei der Mehrzahl der betroffenen Augen ist ein vitreoretinaler Eingriff zur Behandlung der infolge der Malformation aufgetretenen Netzhautablösung indiziert. Die postoperativen Ergebnisse werden dabei in hohem Maß vom Ausprägungsgrad der Fehlbildung determiniert. Trotz erreichter Wiederanlage der Netzhaut bleiben die funktionellen Ergebnisse limitiert. Bei schweren Formen eines PHPV können mittels vitreoretinaler Chirurgie nur Komplikationen verhindert werden. Kann bei diesen Augen keine Lichtreaktion nachgewiesen, keine Pupillenreaktion ausgelöst und/oder kein visuell evoziertes Potenzial mehr ausgelöst werden, so sollte jedoch kein chirurgischer Eingriff mehr durchgeführt werden.

Abstract

A range of posterior segment abnormalities, especially anomalies of the optic papilla, coloboma, and persistent hyperplastic primary vitreous are associated with the high risk to develop a retinal detachment. Most of these retinal detachments develop in the first and second decade of life. In most cases of retinal detachment caused by malformations, vitreoretinal surgery is indicated. Results of surgery depend on the nature of malformations. In spite of an anatomic re-attachment of the retina, in some eyes the functional results are limited. Especially in cases of severe PHPV, the aim of vitrectomy is only to prevent complications. Vitreoretinal surgery should not be performed in eyes with no light perception, without papillary light reflex, and/or with unrecordable visually evoked potential.

Schlüsselwörter

Netzhautablösung - Malformation - Papillenfehlbildung - Kolobom - persistierender hyperplastischer primärer Vitreus

Key words

retinal detachment - malformation - anomalies of optic papilla - coloboma - persistent hyperplastic primary vitreous

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