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Erschienen in: Der Ophthalmologe 5/2015

01.05.2015 | Leitthema

Funktionelle Störungen im zeitlichen Verlauf der Glaukomerkrankung

verfasst von: Prof. Dr. Carl Erb

Erschienen in: Die Ophthalmologie | Ausgabe 5/2015

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Zusammenfassung

Hintergrund

Die glaukomatöse Optikusneuropathie ist ein komplexes Geschehen, das nicht nur zum Untergang von retinalen Ganglienzellen führt, sondern auch das 3. und 4. Neuron ungünstig beeinflusst. In histologischen Studien konnte deshalb im Rahmen eines Glaukoms ein deutlicher Zellverlust sowohl im Corpus geniculatum laterale als auch im visuellen Kortex nachgewiesen werden.

Fragestellung

Durch die Beteiligung der kompletten Sehbahn beim Glaukom kommt es zu einer Vielzahl von funktionellen Störungen, die in dieser Übersicht vorgestellt werden.

Ergebnisse

Neben der Entwicklung der bekannten Gesichtsfeldausfälle kommt es bei der glaukomatösen Optikusneuropathie zu Störungen beim Kontrastsehen, Farbensehen, Stereosehen und zu einer erhöhten Blendempfindlichkeit. Dadurch werden Gesichter schlechter erkannt, die Lesegeschwindigkeit ist herabgesetzt, das Auffinden von Gegenständen wird erschwert, und die Reaktionsgeschwindigkeit lässt nach. Alle diese Veränderungen nehmen mit der Progression des Glaukomschadens zu.

Diskussion

Die Folgen dieser visuellen Einschränkungen führen neben einer zunehmenden sozialen Isolierung zu einer steigenden Gefahr für Stürze und Autounfälle. Dadurch wird die Lebensqualität des Glaukompatienten erheblich vermindert. Deshalb soll in der Betreuung von Glaukompatienten verstärkt auf diese visuellen Schwierigkeiten hingewiesen und das häusliche Umfeld entsprechend umgestaltet werden.
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Metadaten
Titel
Funktionelle Störungen im zeitlichen Verlauf der Glaukomerkrankung
verfasst von
Prof. Dr. Carl Erb
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Ophthalmologie / Ausgabe 5/2015
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-015-0005-y

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