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Intravitreales Triamcinolon und Bevacizumab bei Pigmentepithelabhebung im Rahmen der AMD

Intravitreal administration of triamcinolone and bevacizumab for pigment epithelial detachment in conjunction with AMD

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Zusammenfassung

Hintergrund

In einer retrospektiven Datenanalyse wurde der Effekt der Vascular-endothelial-growth-factor (VEGF)-Hemmer Triamcinolon und Bevacizumab bei Patienten mit einer serösen Pigmentepithelabhebung (PED) bei altersabhängiger Makuladegeneration (AMD) evaluiert.

Patienten und Methoden

Daten von 45 Patienten (45 Augen) wurden analysiert: 11 Patienten erhielten eine einmalige intravitreale Triamcinolonapplikation, 16 eine einmalige intravitreale Bevacizumabeingabe und die restlichen 18 Patienten erhielten keine Therapie. Der Visus, die relative Höhe der PED, die Netzhautdicke und die zystoide Komponente der Netzhaut wurden nach 6 Monaten Nachbeobachtungszeit evaluiert.

Ergebnisse

Nach intravitrealer Bevacizumabeingabe zeigte über 90% der Patienten eine Visusstabilisierung oder -verbesserung. Nach intravitrealer Triamcinoloninjektion kam es bei 63% der Patienten zu einer Visusstabilisierung. Patienten ohne Therapie zeigten eine signifikante Visusverschlechterung.

Schlussfolgerung

Die vorliegenden Daten deuten auf eine bessere Visusprognose nach intravitrealer Bevacizumabeingabe hin. Die Visusprognose scheint eher von der zystoiden Komponente des Netzhautödems als von der Höhe der PED abhängig zu sein. Um diese Befunde zu verifizieren, sind größere Patientenzahlen und längere Nachbeobachtungszeiten erforderlich.

Abstract

Background

The effect of the vascular endothelial growth factor (VEGF) inhibitors triamcinolone and bevacizumab (Avastin) on serous pigment epithelial detachment (PED) related to age-dependent macular degeneration (AMD) was analysed retrospectively.

Patients and Methods

Data of 45 patients (45 eyes) were evaluated: 11 patients received an intravitreal injection with triamcinolone and 16 with bevacizumab. The remaining 18 patients received no therapy. Visual acuity (VA), height of the PED, retinal thickness and the cystoid component of the PED were compared after 6 months follow-up.

Results

Over 90% showed a stabilisation or improvement in VA after bevacizumab therapy; 63% of those who received triamcinolone showed VA stabilisation. Patients who received no therapy had a significant decrease in VA.

Conclusions

Our data seem to implicate that VA outcome is much better after bevacizumab treatment. VA outcome seems to correlate with the cystoid component of the foveal oedema rather than with the height of PED. A greater number of patients with a longer period of follow-up are necessary to confirm these results.

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  1. Augenklinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Hegewischstr. 2, 24105, Kiel, Deutschland

    A. Frimpong-Boateng, M.A. Varde, F. Rüfer, A. Bunse & J. Roider

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  1. A. Frimpong-Boateng
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  2. M.A. Varde
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  3. F. Rüfer
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  4. A. Bunse
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Correspondence to A. Frimpong-Boateng.

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Frimpong-Boateng, A., Varde, M., Rüfer, F. et al. Intravitreales Triamcinolon und Bevacizumab bei Pigmentepithelabhebung im Rahmen der AMD. Ophthalmologe 105, 661–668 (2008). https://doi.org/10.1007/s00347-007-1655-1

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