| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Klinische Monatsblätter für Augenheilkunde | ||||
| Verlag: | GEORG THIEME VERLAG KG | ||||
| Ort der Veröffentlichung: | STUTTGART | ||||
| Band: | 222 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 05 | ||||
| Seitenbereich: | S. 381-388 | ||||
| Datum: | 2005 | ||||
| Institutionen: | Medizin > Lehrstuhl für Augenheilkunde | ||||
| Identifikationsnummer: |
| ||||
| Stichwörter / Keywords: | SUBFOVEAL CHOROIDAL NEOVASCULARIZATION; INTRAVITREAL TRIAMCINOLONE ACETONIDE; RANDOMIZED CLINICAL-TRIAL; MACULAR DEGENERATION; PHOTODYNAMIC THERAPY; VERTEPORFIN THERAPY; OUTCOMES; TAP; LESIONS; age-related macular degeneration; photodynamic therapy; anti-angiogenetic therapy | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 70769 |
Web of ScienceZusammenfassung
Background: Until recently, only two options were available for the treatment of choroidal neovascularization (CNV) due to age-related macular degeneration (AMD): laser photocoagulation and photodynamic therapy (PDT) with verteporfin. However, potential new treatments for CNV are under development, and data from phase III clinical trials are now available. Referring to these data, expert guidance ...
Zusammenfassung
Background: Until recently, only two options were available for the treatment of choroidal neovascularization (CNV) due to age-related macular degeneration (AMD): laser photocoagulation and photodynamic therapy (PDT) with verteporfin. However, potential new treatments for CNV are under development, and data from phase III clinical trials are now available. Referring to these data, expert guidance is required to supply ophthalmologists with expertise in the management of AMD to select and use the most appropriate therapies in the treatment of neovascular AMD. Methods: The therapeutic modalities discussed include thermal laser photocoagulation, PDT with verteporfin, triamcinolone acetonide and the possible combination with PDT, anecortave acetate, pegaptanib sodium and ranibizumab. After a short description of the treatment principles, a summary of the discussion of all relevant study results of the different treatment options with respect to the different subtypes of neovascular AMD is presented. These discussions resulted in an "up-to-date" recommendation of therapeutical strategies in neovascular AMD. Results: For subfoveal lesions with predominantly classic CNV, or with occult with non-classic CNV and a lesion size <= 4 macular photocoagulation study (MPS) disc areas (DA), PDT with verteporfin is recommended; for subfoveal lesions with minimally classic CNV, treatment with PDT or pegaptanib sodium is possible, even if there are some problems with the statistics in the studies with both treatment modalities. PDT with verteporfin should be considered for juxtafoveal lesions that are so close to the fovea that laser photocoagulation would almost certainly extend under the center of the foveal avascular zone, and for all other juxtafoveal lesions and for extrafoveal lesions laser photocoagulation is suggested. Therapy should be performed not later than one week after the initial fluorescein angiogram upon which the clinical decision for treatment is based. At each follow-up best-corrected visual acuity and a fundus examination should be performed as well as a fluorescein angiography every three months. Conclusions: These recommendations provide good clinical guidance for the choice and use of laser and pharmacotherapies for the management of CNV due to AMD. Revisions of the recommendations will be required as new data become available.
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