Pseudophakes zystoides Makulaödem^[*]

Kernaussagen/Empfehlungsstärke

Definition

• Das pseudophake zystoide Makulaödem (PZMÖ) stellt eine Verdickung der zentralen Netzhaut durch eine Flüssigkeitsansammlung infolge abnormer Permeabilität der perifovealen Kapillaren nach Operation der Katarakt dar.

Prävalenz

• Ein PZMÖ mit Visusminderung tritt nach „Kleinschnitt“-Phakoemulsifikation mit Intraokularlinsenimplantation bei unkompliziertem Verlauf in ca. 1,2% (0,1 – 2,4%) auf. Klinisch wenig oder nicht relevante morphologische Veränderungen finden sich in Fluoreszeinangiografie und optischer Kohärenztomographie deutlich häufiger.

Pathogenese

• Dem PZMÖ liegt eine komplexe Genese zugrunde, die lokale Entzündungsmechanismen, Alteration der Blut-Netzhaut-Schranke und morphologische Änderungen des vitreoretinalen Kompartiments betrifft.

Risikofaktoren

• Systemische Risikofaktoren für die Entwicklung eines PZMÖ sind Alter, männliches Geschlecht und Diabetes mellitus: Hier ist das relative Risiko sowohl ohne Vorliegen einer diabetischen Retinopathie als auch bei Vorhandensein einer nicht proliferativen diabetischen Retinopathie und am stärksten bei proliferativer diabetischer Retinopathie erhöht.

• Okuläre Risikofaktoren sind epiretinale Gliose, retinaler Venenverschluss, vorausgegangene Amotiooperation, Uveitis, intraoperative Manipulationen an der Iris, Komplikationen wie Hinterkapseleinriss und/oder Glaskörperprolaps sowie insbesondere anamnestisch PZMÖ am Partnerauge.

Empfehlungsstärke: –

^* Diese Leitlinie erscheint ebenfalls in der Zeitschrift Die Ophthalmologie, Springer Verlag, Heidelberg. Das Redaktionskomitee dieser Stellungnahme wird am Beitragsende gelistet.

Publication History

Article published online:
28 March 2023

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