Subscribe to RSS
DOI: 10.1055/s-0043-124413
Stellungnahme des Berufsverbandes der Augenärzte Deutschlands, der Deutschen Ophthalmologischen Gesellschaft und der Retinologischen Gesellschaft zur Lasertherapie von Drusen bei altersabhängiger Makuladegeneration (AMD)[*]
Stand August 2017Publication History
Publication Date:
26 January 2018 (online)
Kernaussagen
Die konventionelle Laserkoagulation der Drusen bei AMD führt zwar zu einer Regression von Drusen, nach jetzigem Wissensstand aber nicht zu einer Reduktion des Progressionsrisikos der AMD und sollte daher nicht erfolgen.
Neuere „Mikropuls-“ und/oder „Subthreshold-Laserverfahren“ sind bei der frühen und intermediären trockenen AMD (in Abwesenheit von geografischer Atrophie) noch in klinischer Erprobung. Es liegt gegenwärtig keine ausreichende wissenschaftliche Evidenz vor, um die Wirksamkeit bei der AMD abschließend beurteilen zu können.
Aktuell sollen alle Arten möglicher retinaler Lasertherapien bei trockener AMD nicht außerhalb von klinischen Studien durchgeführt werden.
* Dieser Beitrag wird ebenfalls in der Zeitschrift Der Ophthalmologe, Springer Verlag, Berlin Heidelberg 2017, veröffentlicht.
-
Literatur
- 1 Lim LS, Mitchell P, Seddon JM. et al. Age-related macular degeneration. Lancet 2012; 379: 1728-1738 10.1016/S0140-6736(12)60282-7
- 2 Jobling AI, Guymer RH, Vessey KA. et al. Nanosecond laser therapy reverses pathologic and molecular changes in age-related macular degeneration without retinal damage. FASEB J 2015; 29: 696-710 10.1096/fj.14-262444
- 3 Treumer F, Klettner A, Baltz J. et al. Vectorial release of matrix metalloproteinases (MMPs) from porcine RPE-choroid explants following selective retina therapy (SRT): towards slowing the macular ageing process. Exp Eye Res 2012; 97: 63-72 10.1016/j.exer.2012.02.011
- 4 Marshall J, Mellerio J. Pathological development of retinal laser photocoagulations. Exp Eye Res 1967; 6: 303-308 10.1016/S0014-4835(67)80002-2
- 5 Del Priore LV, Glaser BM, Quigley HA. et al. Response of pig retinal pigment epithelium to laser photocoagulation in organ culture. Arch Ophthalmol 1989; 107: 119-122 10.1001/archopht.1989.01070010121039
- 6 Framme C, Kobuch K, Eckert E. et al. RPE in perfusion tissue culture and its response to laser application. Preliminary report. Ophthalmologica 2002; 216: 320-328 10.1159/000066184
- 7 Wallow IH. Repair of the pigment epithelial barrier following photocoagulation. Arch Ophthalmol 1984; 102: 126-135 10.1001/archopht.1984.01040030104047
- 8 Framme C, Roider J, Brinkmann R. et al. Basic principles and clinical application of retinal laser therapy. Klin Monatsbl Augenheilkd 2008; 225: 259-268 10.1055/s-2008-1027202
- 9 Frennesson C, Nilsson SE. Prophylactic laser treatment in early age related maculopathy reduced the incidence of exudative complications. Br J Ophthalmol 1998; 82: 1169-1174
- 10 Sigelman J. Foveal drusen resorption one year after perifoveal laser photocoagulation. Ophthalmology 1991; 98: 1379-1383 10.1016/S0161-6420(91)32122-5
- 11 Wetzig PC. Treatment of drusen-related aging macular degeneration by photocoagulation. Trans Am Ophthalmol Soc 1988; 86: 276-290
- 12 Guymer RH, Gross-Jendroska M, Owens SL. et al. Laser treatment in subjects with high-risk clinical features of age-related macular degeneration. Posterior pole appearance and retinal function. Arch Ophthalmol 1997; 115: 595-603 10.1001/archopht.1997.01100150597004
- 13 Little HL, Showman JM, Brown BW. A pilot randomized controlled study on the effect of laser photocoagulation of confluent soft macular drusen. Ophthalmology 1997; 104: 623-631 10.1016/S0161-6420(97)30261-9
- 14 Sarks SH, Arnold JJ, Sarks JP. et al. Prophylactic perifoveal laser treatment of soft drusen. Aust N Z J Ophthalmol 1996; 24: 15-26 10.1111/j.1442-9071.1996.tb01546.x
- 15 Figueroa MS, Regueras A, Bertrand J. et al. Laser photocoagulation for macular soft drusen. Updated results. Retina 1997; 17: 378-384
- 16 Choroidal Neovascularization Prevention Trial Research Group. Choroidal neovascularization in the Choroidal Neovascularization Prevention Trial. Ophthalmology 1998; 105: 1364-1372 10.1016/S0161-6420(98)98014-9
- 17 Choroidal Neovascularization Prevention Trial Research Group. Laser treatment in eyes with large drusen. Short-term effects seen in a pilot randomized clinical trial. Ophthalmology 1998; 105: 11-23
- 18 Virgili G, Michelessi M, Parodi MB. et al. Laser treatment of drusen to prevent progression to advanced age-related macular degeneration. Cochrane Database Syst Rev 2015; (10) CD006537
- 19 Olk RJ, Friberg TR, Stickney KL. et al. Therapeutic benefits of infrared (810-nm) diode laser macular grid photocoagulation in prophylactic treatment of nonexudative age-related macular degeneration: two-year results of a randomized pilot study. Ophthalmology 1999; 106: 2082-2090 10.1016/S0161-6420(99)90487-6
- 20 Framme C, Roider J. Immediate and long-term changes of fundus autofluorescence in continuous wave laser lesions of the retina. Ophthalmic Surg Lasers Imaging 2004; 35: 131-138
- 21 Morgan CM, Schatz H. Atrophic creep of the retinal pigment epithelium after focal macular photocoagulation. Ophthalmology 1989; 96: 96-103 10.1016/S0161-6420(89)32924-1
- 22 Lee H, Alt C, Pitsillides CM. et al. Optical detection of intracellular cavitation during selective laser targeting of the retinal pigment epithelium: dependence of cell death mechanism on pulse duration. J Biomed Opt 2007; 12: 64034 10.1117/1.2804078
- 23 Brinkmann R, Schule G, Neumann J. et al. Selective retina therapy: methods, technique, and online dosimetry. Ophthalmologe 2006; 103: 839-849 10.1007/s00347-006-1416-6
- 24 Framme C, Schuele G, Roider J. et al. Influence of pulse duration and pulse number in selective RPE laser treatment. Lasers Surg Med 2004; 34: 206-215 10.1002/lsm.20022
- 25 Roider J, Hillenkamp F, Flotte T. et al. Microphotocoagulation: selective effects of repetitive short laser pulses. Proc Natl Acad Sci U S A 1993; 90: 8643-8647
- 26 Roider J, Michaud NA, Flotte TJ. et al. Response of the retinal pigment epithelium to selective photocoagulation. Arch Ophthalmol 1992; 110: 1786-1792 10.1001/archopht.1992.01080240126045
- 27 Schuele G, Rumohr M, Huettmann G. et al. RPE damage thresholds and mechanisms for laser exposure in the microsecond-to-millisecond time regimen. Invest Ophthalmol Vis Sci 2005; 46: 714-719 10.1167/iovs.04-0136
- 28 Dorin G. Subthreshold and micropulse diode laser photocoagulation. Semin Ophthalmol 2003; 18: 147-153 10.1076/soph.18.3.147.29812
- 29 Vujosevic S, Martini F, Longhin E. et al. Subthreshold micropulse yellow laser versus subthreshold micropulse infrared laser in center-involving diabetic macular edema: morphologic and functional safety. Retina 2015; 35: 1594-1603 10.1097/IAE.0000000000000521
- 30 Gabel VP, Birngruber R, Hillenkamp F. Visible and near infrared Light Absorption in Pigment Epithelium and Choroid. In: Shimizu K. eds. Visible and near infrared Light Absorption in Pigment Epithelium and Choroid. Kyoto: Excerpta Medica; 1978: 658-662
- 31 Iwami H, Pruessner J, Shiraki K. et al. Protective effect of a laser-induced sub-lethal temperature rise on RPE cells from oxidative stress. Exp Eye Res 2014; 124: 37-47 10.1016/j.exer.2014.04.014
- 32 Rodanant N, Friberg TR, Cheng L. et al. Predictors of drusen reduction after subthreshold infrared (810 nm) diode laser macular grid photocoagulation for nonexudative age-related macular degeneration. Am J Ophthalmol 2002; 134: 577-585 10.1016/S0002-9394(02)01691-4
- 33 Scorolli L, Corazza D, Morara M. et al. Argon laser vs. subthreshold infrared (810-nm) diode laser macular grid photocoagulation in nonexudative age-related macular degeneration. Can J Ophthalmol 2003; 38: 489-495 10.1016/S0008-4182(03)80028-5
- 34 Friberg TR, Brennen PM, Freeman WR. et al. Prophylactic treatment of age-related macular degeneration report number 2: 810-nanometer laser to eyes with drusen: bilaterally eligible patients. Ophthalmic Surg Lasers Imaging 2009; 40: 530-538 10.3928/15428877-20091030-01
- 35 Friberg TR, Musch DC, Lim JI. et al. Prophylactic treatment of age-related macular degeneration report number 1: 810-nanometer laser to eyes with drusen. Unilaterally eligible patients. Ophthalmology 2006; 113: 622.e1 10.1016/j.ophtha.2005.10.066
- 36 Mojana F, Brar M, Cheng L. et al. Long-term SD-OCT/SLO imaging of neuroretina and retinal pigment epithelium after subthreshold infrared laser treatment of drusen. Retina 2011; 31: 235-242 10.1097/IAE.0b013e3181ec80ad
- 37 Roider J, Brinkmann R, Wirbelauer C. et al. Subthreshold (retinal pigment epithelium) photocoagulation in macular diseases: a pilot study. Br J Ophthalmol 2000; 84: 40-47
- 38 Framme C, Brinkmann R, Birngruber R. et al. Autofluorescence imaging after selective RPE laser treatment in macular diseases and clinical outcome: a pilot study. Br J Ophthalmol 2002; 86: 1099-1106
- 39 Framme C, Walter A, Prahs P. et al. Structural changes of the retina after conventional laser photocoagulation and selective retina treatment (SRT) in spectral domain OCT. Curr Eye Res 2009; 34: 568-579 10.1080/02713680902964892
- 40 Guymer RH, Brassington KH, Dimitrov P. et al. Nanosecond-laser application in intermediate AMD: 12-month results of fundus appearance and macular function. Clin Experiment Ophthalmol 2014; 42: 466-479 10.1111/ceo.12247