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Therapie der myopen choroidalen Neovaskularisation

Therapy of myopic choroidal neovascularization

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Zusammenfassung

Die ersten Fallserien beschreiben die Wirksamkeit der VEGF („vascular endothelial growth factor“)-Inhibitoren über den Zeitraum mehrerer Jahre, während die photodynamische Therapie in der prospektiven VIP-Studie keinen signifikanten Unterschied gegenüber einer Placebobehandlung vorweisen konnte. Obwohl systemische Untersuchungen verschiedener Wiederbehandlungsregime bis heute fehlen, scheint die Gabe einzelner Injektionen nach der fachärztlichen Beurteilung der morphologischen Veränderungen häufig schon mit wenigen Applikationen gute Ergebnisse erreichen zu können. Die Bedingungen der IVOM (intravitreale operative Medikamenteneingabe)-Therapie dürfen nicht einfach von der altersabhängigen Makuladegeneration übertragen werden. Eine individuelle Betreuung scheint – nicht nur bei Frauen im gebärfähigen Alter – angeraten.

Abstract

Recently published studies have shown that myopic choroidal neovascularization (mCNV) is efficiently treated by anti-vascular endothelial growth factor (VEGF) drugs. Within a prospective executive study, photodynamic therapy failed to prove a significant difference over the duration of 2 years. Although a systematic evaluation of different retreatment algorithms still has to be done the administration of single injections depending on specialist assessment of morphological changes, predominantly spectral domain optical coherence tomography (SD-OCT) and fundus, has achieved a marked visual improvement. The experience of treating age-related macular degeneration should not be simply transferred to mCNV and an individual approach, not only for female patients of childbearing age, is necessary.

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Focke Ziemssen hat Honorare und Reisekosten von Alimera, Allergan, Bayer Healthcare, GSK, Heidelberg Engineering, Novartis und Pfizer erhalten. Trotz eines möglichen Interessenkonflikts bemüht sich der Beitrag um eine unabhängige und neutrale Bewertung: K.U. Bartz-Schmidt hat Honorare bzw. Forschungsunterstützung von Allergan, Bayer Healthcare, GSK, Novartis und Pfizer erhalten. Dennoch bemüht sich der Artikel um eine ausgewogene und unabhängige Darstellung der Therapiealternativen.

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  1. Department für Augenheilkunde, Universität Tübingen, Schleichstr. 12–16, 727076, Tübingen, Deutschland

    B. Voykov, F. Ziemssen & K.U. Bartz-Schmidt

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  1. B. Voykov
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  3. K.U. Bartz-Schmidt
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Correspondence to B. Voykov.

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Voykov, B., Ziemssen, F. & Bartz-Schmidt, K. Therapie der myopen choroidalen Neovaskularisation. Ophthalmologe 109, 766–769 (2012). https://doi.org/10.1007/s00347-011-2500-0

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