Autofluoreszenz des humanen retinalen Pigmentepithels in der normalen Alterung und bei altersbedingter Makuladegeneration: Histologie und Klinik

Zusammenfassung

Fundusautofluoreszenz(FAF)-Aufnahmen zählen seit beinahe 2 Jahrzehnten zur Routinediagnostik des menschlichen Augenhintergrunds. Die stetigen Weiterentwicklungen der Aufnahmetechniken ermöglichen heute eine sichere, nicht invasive, einfach durchführbare und reproduzierbare Darstellung des Augenhintergrunds. Die zugrunde liegende Technik macht sich die autofluoreszierenden Eigenschaften von Geweben, insbesondere des retinalen Pigmentepithels (RPE) und dessen Fluorophore, zunutze. Dadurch können FAF-Aufnahmen in hervorragender Weise Phänomene der normalen Alterung sowie krankheitsbedingte Veränderungen des Augenhintergrunds aufzeigen, aber auch Informationen zu Krankheitsverlauf und Therapiekontrolle liefern. In dieser Übersichtsarbeit sollen nach einer kurzen Einführung in die Basis der Fundusautofluoreszenz neueste grundlagenwissenschaftliche Kenntnisse zur Histologie im Hinblick auf altersbedingte und pathologische Veränderungen des RPE zusammengefasst werden, um so eine bessere Interpretation von FAF-Aufnahmen zu ermöglichen. Der Darstellung altersbedingter Veränderungen werden hierbei die pathologischen Veränderungen im Rahmen einer altersbedingten Makuladegeneration sowohl klinisch als auch auf histologischer Ebene gegenübergestellt.

Abstract

Autofluorescence images of the fundus have been part of the routine diagnostics of the human eye for almost two decades. Further development of imaging techniques makes fundus autofluorescence (FAF) imaging a safe, non-invasive, easy-to-perform and reproducible diagnostic tool. FAF uses the autofluorescent properties of tissues, in particular the retinal pigment epithelium (RPE) and its fluorophores. FAF images display phenomena of normal aging as well as disease-related changes of the fundus, but also can be used for monitoring retinal diseases and therapy. After a short introduction into the basics of FAF, the results of the latest histology studies regarding age-related and pathological changes of the human RPE will be summarized for a better understanding and interpretation of FAF images. The normal age-related changes of the RPE are contrasted with the pathological changes in age-related macular degeneration, both clinically and histologically.

Schlüsselwörter

retinales Pigmentepithel - Autofluoreszenz - Lipofuszin - altersbedingte Makuladegeneration - Mikroskopie - Histologie

Key words

retinal pigment epithelium - autofluorescence - lipofuscin - age-related macular degeneration - microscopy - histology

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