Zusammenfassung
Subretinale Blutungen können als Komplikation verschiedener Erkrankungen entstehen und entstammen entweder der choroidalen oder retinalen Zirkulation. Mit Abstand die häufigste Ursache ist eine choroidale Neovaskularisationsmembran (CNV) bei altersassoziierter Makuladegeneration (AMD), gefolgt von anderen Erkrankungen mit einer CNV und von retinalen arteriellen Makroaneurysmen (RAM). Im Allgemeinen haben subretinale Blutungen eine ernste Visusprognose, wobei es Ausnahmen mit günstigem Spontanverlauf gibt. Das macht die Entscheidung für oder gegen therapeutische Interventionen schwierig. Aufgrund des heterogenen Erscheinungsbildes submakulärer Blutungen wird eine Klassifikation vorgeschlagen, um neue Studienprotokolle zu erstellen und die verschiedenen Therapieoptionen zu bewerten.
Abstract
Subretinal hemorrhages are a complication of various diseases which arise from the choroidal or retinal circulation. Most commonly the underlying pathology is a choroidal neovascular membrane (CNV) especially in patients with age-related macular degeneration (AMD). Less common ocular diseases are those with non-AMD-related CNV and retinal arterial macroaneurysms (RAM). Case studies have demonstrated a poor prognosis, however, a significant portion have favorable outcomes. Therefore, therapeutic decision-making is difficult. As a major difficulty in comparing different treatment modalities for submacular hemorrhages is the lack of a standardized definition of the extent of the hemorrhage. A classification for AMD-related subretinal hemorrhages including size, thickness and intraretinal location is suggested.
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Bopp, S. Subretinale Blutungen. Ophthalmologe 109, 635–643 (2012). https://doi.org/10.1007/s00347-012-2563-6
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DOI: https://doi.org/10.1007/s00347-012-2563-6
Schlüsselwörter
- Submakuläre Blutung
- Altersassoziierte Makuladegeneration
- Retinales arterielles Makroaneurysma
- Subretinale Blutung
- Choroidale Neovaskularisationsmembran