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Augenheilkunde up2date 2023; 13(03): 221-241
DOI: 10.1055/a-2068-0631
Netzhaut, Glaskörper, Augenhintergrund

Seltene vaskuläre Erkrankungen der Netzhaut – Teil 1

Less Frequent Vascular Disorders of the Retina – Part 1
Heinrich Heimann
,
Andreas Schüler
,
Ulrich Kellner
,
Albrecht Lommatzsch
,
Lothar Krause
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Zusammenfassung

Neben der diabetischen Retinopathie und den arteriellen und venösen Verschlusserkrankungen existiert eine Reihe weiterer Ursachen für vaskuläre Netzhauterkrankungen, deren Früherkennung für die Differenzialdiagnose und Therapie bedeutsam sind. Diese Übersicht stellt wichtige generalisierte oder periphere vaskuläre Netzhauterkrankungen vor. Der zweite Teil fasst vaskuläre Netzhauterkrankungen mit vorwiegend makulärer Symptomatik zusammen.

Abstract

This review provides an overview of retinal vascular disorders that are less frequent in Germany and Europe compared to diabetic retinopathy and retinal venous or arterial occlusive disorders. The knowledge of these disorders is important for the differential diagnosis of retinal vascular disorders as well as potentially associated systemic disorders. In the current part one epidemiology, pathophysiology, clinical presentation, and therapy are discussed for hypertensive retinochoroidopathy, ocular ischemic syndrome, retinal alterations in sickle cell disease, Eales disease, radiation retinopathy, peripheral exudative hemorrhagic chorioretinopathy, and retinal disorders associated with pregnancy.

Kernaussagen

  • Die Kenntnis und Abgrenzung seltener vaskulärer Netzhauterkrankungen ist wesentlich zur Frühdiagnose und adäquaten Therapieentscheidung in Bezug auf okuläre und systemische Veränderungen.

  • Bei einigen der Erkrankungen ermöglichen OCT und OCTA eine Früherkennung.

  • Eine Hypertonie begünstigt vaskuläre Netzhauterkrankungen und kann für sich eine Chorioretinopathie oder Optikopathie verursachen.

  • Beim okulären Ischämiesyndrom ist die verzögerte Gefäßfüllung in der FAG richtungsweisend.

  • Der Verlauf einer Sichelzellretinopathie ist sehr variabel, regelmäßige Kontrollen sind sinnvoll.

  • Der Morbus Eales wird meist durch sekundäre Komplikationen symptomatisch und erfordert eine stadienabhängig angepasste Therapie.

  • Eine Strahlenretinopathie tritt in der Regel deutlich verzögert auf.

  • Die periphere exsudative hämorrhagische Chorioretinopathie erfordert eine Weitwinkelbildgebung; eine evidenzbasierte Therapie existiert nicht.

  • Retinale Veränderungen in der Schwangerschaft zeigen sich akut selten im Rahmen einer schwangerschaftsinduzierten Hypertonie. Bei diabetischer Retinopathie und Uveitis sind häufigere Kontrollen sinnvoll.

Schlüsselwörter

Hypertensive Retinopathie - okuläres Ischämiesyndrom - Sichelzellretinopathie - Morbus Eales - schwangerschaftsinduzierte Chorioretinopathie

Key words

Hypertensive retinopathy - ocular ischemic syndrome - sickle cell retinopathy - Eales disease - pregnancy-induced chorioretinopathy


Publication History

Article published online:
16 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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