Myope CNV

Zusammenfassung

Die choroidale Neovaskularisation stellt die häufigste Ursache für eine schwere Sehverschlechterung und einen Verlust der Lesefähigkeit bei (zumeist jungen) Patienten mit degenerativer Myopie dar. Die besonderen Charakteristika der CNV im Unterschied zur altersabhängigen Makuladegeneration sowie die anatomischen Besonderheiten des hochmyopen Auges haben einen entscheidenden Einfluss auf die Möglichkeiten der Basis- und Verlaufsdiagnostik. Weil die kleinen fibrovaskulären Membranen unbehandelt zu einer schnellen Schädigung der Photorezeptoren führen, ist angesichts der schlechten Spontanprognose eine zeitnahe Behandlung erforderlich. Nicht zuletzt die überlegenen funktionellen Ergebnisse der anti-VEGF-Therapie haben zu deren Stellenwert als First-line-Therapie beigetragen. Es gibt Hinweise, dass PRN-basierte Behandlungsalgorithmen eine geringere Dosierung als bei anderen Pathologien erlauben.

Abstract

Choroidal neovascularisation secondary to pathological myopia is the most common cause of severe visual impairment in myopic patients younger than 50 years old. The typical features of myopic CNV in contrast to age-related macular degeneration as well as the anatomic characteristics have an impact on the parameters of the baseline and follow-up examinations. As the usually small fibrovascular lesions show a rapid progression in the spontaneous course of the disease and lead to irreversible damage to the photoreceptors, prompt initiation of treatment is mandatory. The superior functional results of anti-VEGF drugs provide the reason for the first-line status of this treatment modality. Increasing safety data and consistent results of prospective pilot trials have proved photodynamic therapy to be inferior. There are signs that PRN-based treatment algorithms may allow for less frequent dosing than in other retinal diseases.

Schlüsselwörter

myope CNV - anti-VEGF - Bevacizumab - Ranibizumab - Photodynamische Therapie - Lacksprung

Key words

myopic CNV - anti-VEGF - bevacizumab - ranibizumab - photodynamic therapy - lacquer crack

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