Proliferative Vitreoretinopathie – Pathogenese und Therapie

 

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Zusammenfassung

Die wichtigste Komplikation der Netzhautablösung und der vitreoretinalen Chirurgie ist die proliferative Vitreoretinopathie (PVR). Die PVR ist ein überaktivierter Prozess der Netzhautreparatur; die Proliferation von retinalen und Immunzellen führt zur Bildung von epiretinalen Membranen, deren Traktionen Netzhautablösungen verursachen. Dieser Artikel gibt einen kurzen Überblick über die Pathogenese und die chirurgische Behandlung der PVR sowie über bisherige Studien zur Testung von pharmakologischen Substanzen, die zur Inhibition der intraokulären Proliferation eingesetzt werden könnten. Zurzeit sind rein chirurgische Methoden das Mittel der Wahl zur Behandlung einer PVR. Eine PVR der Stadien B und C1 / C2 kann mit Buckelchirurgie behandelt werden. Ab dem Stadium C 3 sollte eine Vitrektomie durchgeführt werden.

Abstract

Proliferative vitreoretinopathy (PVR) is the most important complication of retinal detachment and vitreoretinal surgery. PVR is considered to represent a maladapted retinal wound repair process; proliferation of retinal and immune cells induces the formation of epiretinal membranes which cause tractional retinal detachment. This publication gives a brief overview on the pathogenesis and operative treatment of PVR as well as on adjunct pharmacological therapy which may target the components of the proliferative process. At the moment surgical approaches are the first choice for the treatment of PVR. Scleral buckling provides good anatomic results in the treatment of a PVR stage B or C1 / C2. From stage C 3 onwards vitrectomy offers advantage.

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Prof. Dr. Peter Wiedemann

Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig AöR

Liebigstr. 10 – 14

04103 Leipzig

Phone: ++ 49/3 41/9 72 16 50

Email: augen@medizin.uni-leipzig.de