RSS-Feed abonnieren
DOI: 10.1055/s-2008-1027606
© Georg Thieme Verlag KG Stuttgart · New York
Massive subretinale Blutung bei AMD am letzten Auge – behandeln oder nicht?
Massive Subretinal Bleeding – Treat it or Leave it?Publikationsverlauf
Eingegangen: 19.1.2008
Angenommen: 1.6.2008
Publikationsdatum:
15. Dezember 2008 (online)

Zusammenfassung
Bei Augen mit massiver subretinaler Blutung kann ein orientierendes Sehen durch eine Pars-plana-Vitrektomie mit subretinaler Chirurgie erreicht werden. Bei Patienten mit Oculus-ultimus-Situation ist dies wichtig, um ihre Lebensqualität besser zu optimieren. Der resultierende große Pigmentepitheldefekt begrenzt die Visusrehabilitation. Eine alleinige rTPA- und Gasinjektion bzw. eine Makulatranslokation sind in diesen Fällen möglich, aber nicht wirksam genug.
Abstract
In eyes with massive subretinal haemorrhages, ambulatory vision can be achieved by pars plana vitrectomy and subretinal surgery. In patients with only one functional eye, this treatment is important to preserve the quality of life. The resulting large pigment epithelial defect limits visual rehabilitation. For the same reason, rTPA/gas injection or a macular translocation are possible but not sufficient in these cases.
Schlüsselwörter
Massive subretinale Blutung - subretinale Chirurgie - Pigmentepitheldefekt
Key words
massive subretinal haemorrhages - subretinal surgery - pigment epithelial defect
Literatur
- 1
Bressler N M, Bressler S B, Childs A L. et al .
Surgery of hemorrhagic choroidal neovascular lesions of age-related macular degeneration:
ophthalmic findings: SST report no. 13.
Ophthalmology.
2004;
111 (11)
1993-2006
MissingFormLabel
- 2
Dixsaut F, Postelmans L, Verougstraete C.
Massive subretinal hemorrhage in the course of age-related macular degeneration: preliminary
study.
Bull Soc Belge Ophthalmol.
1995;
259
97-105
MissingFormLabel
- 3
Hesse L, Schroeder B, Heller G.
Quantitative effect of intravitreally injected tissue plasminogen activator and gas
on subretinal hemorrhage.
Retina.
2000;
20
500-505
MissingFormLabel
- 4
Joussen A M, Heussen F M, Joeres S.
Autologous translocation of the choroid and retinal pigment epithelium in age-related
macular degeneration.
Am J Ophthalmol.
2006;
142
17-30
MissingFormLabel
- 5
Kroll P, Meyer C H.
Which treatment is the best for which AMD patient?.
Br J Ophthalmol.
2006;
90
128-130
MissingFormLabel
- 6
Matsuo T, Shiraga F, Takasu I.
Planned two-step vitrectomy for extremely large and thick subretinal hematoma.
Acta Ophthalmol Scand.
2001;
79
533-537
MissingFormLabel
- 7
Meyer C H, Scholl H P, Eter N. et al .
Combined treatment of acute subretinal haemorrages with intravitreal recombined tissue
plasminogen activator, expansile gas and bevacizumab: a retrospective pilot study.
Acta Ophthalmol Scand.
2008;
24 (im Druck)
MissingFormLabel
- 8
Michels S, Prager F, Stifter E. et al .
Intravitreal bevacizumab therapy for neovascular age-related macular degeneration
with large submacular hemorrhage.
Am J Ophthalmol.
2007;
144 (6)
886-892
MissingFormLabel
- 9
Oshima Y, Ohji M, Tano Y. et al .
Pars plana vitrectomy with peripheral retinotomy after injection of preoperative intravitreal
tissue plasminogen activator: a modified procedure to drain massive subretinal haemorrhage.
Br J Ophthalmol.
2007;
91
193-198
MissingFormLabel
- 10
Petersen J, Meyer-Riemann W, Ritzau-Tondrow U. et al .
Visual fields after removal of subretinal hemorrhages and neovascular membranes in
age-related macular degeneration.
Graefes Arch Clin Exp Ophthalmol.
1998;
236
241-247
MissingFormLabel
- 11
Schmidt J C, Meyer C H, Hoerle S.
Die subretinale Massenblutung – eine Herausforderung für den Glaskörperchirurgen.
Ophthalmologe.
2004;
101 (6)
584-588
MissingFormLabel
- 12
Scupola A, Coscas G, Soubrane G. et al .
Natural history of macular subretinal hemorrhage.
Ophthalmologica.
1999;
213 (2)
97-102
MissingFormLabel
- 13
Treumer F, Klatt C, Roider J.
Autologe RPE-Chorioidea-Translokation bei exsudativer AMD.
Ophthalmologe.
2007;
104
795-802
MissingFormLabel
- 14
Vander J F, Federman J L, Greven C. et al .
Surgical removal of massive subretinal hemorrhage associated with age-related macular
degeneration.
Ophthalmology.
1991;
98 (1)
23-27
MissingFormLabel
Dr. Frank Michael Schroeder
Augenklinik, Philipps-Universität Marburg
Robert Koch Straße 4
35037 Marburg
Telefon: ++ 49/64 21/2 86 26 00
Fax: ++ 49/64 21/2 86 26 54
eMail: michaelschroeder@web.de