Interpretation pathologischer Veränderungen am vitreoretinalen Interface

Zusammenfassung

Jahrzehntelang bestand bez. der Diagnostik und chirurgischen Behandlung von symptomatischen, pathologischen Veränderungen am vitreomakulären Interface (VMI) Konsens. Durch die Einführung der SD-OCT-Bildgebung wurde das Verständnis pathogenetischer Prozesse an dieser Grenzfläche deutlich vertieft, und es konnten prospektive Faktoren beim makulären Traktionssyndrom, der epiretinalen Membranen (ERM) und auch bei Makulaforamen (MF) definiert werden. Nach der Zulassung von Ocriplasmin zur nicht chirurgischen Behandlung von vitreomakulären Traktionen (VMT) und kleinen MF konnte aufgrund dieser Behandlungsergebnisse und neuer Bildgebungstechniken eine neue Klassifikation erstellt werden. Somit ist eine präzise Trennung physiologischer, altersbedingter Veränderungen am VMI und pathologischer Veränderung möglich. In einer Literatursichtung wird über klinisch relevante Aspekte bei der Diagnostik und Therapie von Erkrankungen am VMI berichtet.

Abstract

For decades there was a general consensus about diagnostic investigations and surgical treatment of symptomatic pathological changes in the vitreomacular interface (VMI). The introduction of SD-OCT imaging helped in the understanding of the pathogenetic processes at this interface and risk factors were defined for the macular traction syndrome, epiretinal membrane (ERM) and macular hole. After approval of ocriplasmin for non-surgical treatment, a new classification based on treatment outcome and new imaging techniques was established. Precise separation of physiological, age-related changes in the VMI and pathological changes was then possible. Clinically relevant aspects in the diagnostic testing and treatment of diseases of the VMI are reported in this literature review.

Schlüsselwörter

Glaskörper - Retina - vitreomakuläre Grenzfläche - Makulaforamen - epiretinale Gliose

Key words

vitreous - retina - macular hole - epiretinal membrane

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