Joussen A M, Kirchhof B
Abteilung für Netzhaut- und Glaskörperchirurgie, Zentrum für Augenheilkunde der Universität zu Köln.
Ophthalmologe. 2004 Oct;101(10):1035-47; quiz 1048-9. doi: 10.1007/s00347-004-1107-0.
This report reviews the clinical appearance of degenerative diseases of the peripheral retina in relationship to the risk of developing a rhegmatogenous retinal detachment. We present recommendations for preventive treatment in eyes at increased risk of developing retinal detachment. Retinal degenerations are common lesions involving the peripheral retina but most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and very rarely zonular traction tufts can result in rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic treatment; however, adequate studies have not been performed to date. Most of the peripheral retinal degenerations may not require treatment except in rare, high-risk situations. According to current knowledge there is no higher incidence of secondary pucker or other side effects after laser coagulation. Therefore, generous laser indication is recommended if risk factors apply.
本报告回顾了周边视网膜退行性疾病的临床表现及其与发生孔源性视网膜脱离风险的关系。我们针对发生视网膜脱离风险增加的眼睛提出预防性治疗建议。视网膜变性是累及周边视网膜的常见病变,但大多数在临床上并无重要意义。格子样变性、退行性视网膜劈裂、视网膜囊肿性簇以及极罕见的 zonular 牵引性簇可导致孔源性视网膜脱离。因此,这些病变已被考虑进行预防性治疗;然而,迄今为止尚未进行充分的研究。除了在罕见的高风险情况下,大多数周边视网膜变性可能无需治疗。根据目前的知识,激光凝固术后继发性皱襞或其他副作用的发生率并无升高。因此,如果存在风险因素,建议广泛应用激光治疗。