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Langzeiteffekt und Sicherheit der fokalen Laserkoagulation bilateraler Drusen bei altersbedingter Makuladegeneration

Long-term effect and safety of focal laser coagulation of bilateral drusen in age-related macular degeneration

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Zusammenfassung

Die fokale Laserkoagulation bilateraler Drusen zur Prophylaxe einer schweren Sehbehinderung durch fortgeschrittene altersbedingte Makuladegeneration ist ein neues therapeutisches Konzept, das auf seine Wirksamkeit und Sicherheit im Langzeitverlauf überprüft werden muss. Zu diesem Zweck wurde in einer Pilotstudie ein homogenes Kollektiv von zehn konsekutiven Patienten an einem Auge standardisiert behandelt. Die Partneraugen fungierten als Kontrollgruppe. Nach einer medianen Nachbeobachtungsdauer von 3,9 Jahren wies die Behandlungsgruppe im Bezug zur Kontrollgruppe eine um 0,6 Zeilen geringere Visusreduktion (p = 0,2) und eine signifikante Reduktion der Drusenfläche (p = 0,04) auf. 77,8% der behandelten Augen hatten sichtbare Zeichen einer Drusenresorption. In der Behandlungsgruppe entwickelte kein Auge eine Komplikation im Sinne einer atrophen oder neovaskulären Makulopathie. Im Gegensatz dazu entstand in einem (11,1%) von 9 Augen der Kontrollgruppe eine choroidale Neovaskularisation. Die hier vorliegenden Ergebnisse belegen die potentielle Wirksamkeit und nachhaltende Sicherheit der fokalen Laserkoagulation von bilateralen Drusen in Rahmen der altersbedingten Makuladegeneration.

Summary

The prophylactic laser treatment of bilateral early age-related macular degeneration induces accelerated regression of macular drusen. To assess the therapeutic effect on retinal morphology and visual function, we conducted a pilot study with 20 eyes of 10 consecutive patients. The median time of follow-up was 3,9 years. In comparison to the untreated partner-eyes, the treated eyes showed a, although insignificant, minor loss of visual acuity of 1,4 versus 0,8 lines on the ETDRS-chart. Regression of drusen area was significantly greater in the treatment group (p = 0,04). 77,8% of the treated eyes demonstrated at least some resorption of Drusen. Drusen that did not respond, showed either massive confluence or pronounced flattening. None of the treated eyes developed either choroidal neovascularization (CNV) or atrophy. On the contrary, one eye (11,1%) in the control group developed CNV. The results of this pilot trial suggest the beneficial effect and a long-term safety of the focal laser treatment of bilateral drusen in age-related macular degeneration.

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  1. Klinik für Augenheilkunde und Optometrie, Universität Wien, Währinger Gürtel 18-20, A-1096, Wien

    M. Tittl, Noemi Maar & M. Stur

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  1. M. Tittl
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  2. Noemi Maar
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  3. M. Stur
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Tittl, M., Maar, N. & Stur, M. Langzeiteffekt und Sicherheit der fokalen Laserkoagulation bilateraler Drusen bei altersbedingter Makuladegeneration. Spektrum Augeheilkd 13, 202–207 (1999). https://doi.org/10.1007/BF03162762

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