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Klin Monbl Augenheilkd 2023; 240(03): 316-326
DOI: 10.1055/a-2019-9748
Statement

Pseudophakes zystoides Makulaödem[*]

Stellungnahme der Deutschen Ophthalmologischen Gesellschaft, der Retinologischen Gesellschaft und des Berufsverbandes der Augenärzte Deutschlands. Stand 22.10.2022Pseudophakic Cystoid Macular EdemaStatement of the German Society of Ophthalmology, the German Retina Society and the German Professional Association of Ophthalmologists. Status 22 October 2022 Deutsche Ophthalmologische Gesellschaft (DOG), Retinologische Gesellschaft e.V. (RG), Berufsverband der Augenärzte Deutschlands e.V. (BVA)
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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

© 2023. Thieme. All rights reserved.

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