Höh A E, Schaal K B, Dithmar S
Schwerpunkt Retinologie, Universitätsaugenklinik Heidelberg, Heidelber, Germany.
Ophthalmologe. 2007 Apr;104(4):290-4. doi: 10.1007/s00347-007-1514-0.
The main object of this study was to find out what treatment methods are currently preferred for central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) in Germany, Austria and Switzerland.
A questionnaire concerning the different medicamentous, surgical and laser treatments available for CRVO and BRVO was developed and sent out to the members of the German Retina Society.
This analysis is based on 124 returned questionnaires. We found that 64% of our colleagues recommend isovolemic hemodilution in patients with CRVO. Pentoxyfyllin infusions are endorsed by 32% and 27%, respectively, for CRVO and BRVO. Panretinal photocoagulation is applied only if neovascularization is present by 39% of those responding, whereas 61% perform prophylactic photocoagulation when there is no visible neovascularization, depending on the degree of ischemia. In the case of macular edema due to BRVO 52% recommend macular grid photocoagulation. Sheathotomy is recommended by 51% for BRVO suggest, and 43% advise radial optic neurotomy (RON) for CRVO. Intravitreal injection of triamcinolone is performed for CRVO or BRVO by 58% and 56%, respectively, and para-bulbar injection of triamcinolone by 2% and 3%. Intravitreal anti-VEGF treatment is applied by 72% of respondents, the majority (94%) using bevacizumab for this purpose.
Members of the German Retina Society apply widely differing treatments in patients with CRVO and BRVO. Further clinical studies to evaluate the different therapeutic options seem necessary in order to set up guidelines for the treatment of venous retinal occlusions.
本研究的主要目的是了解德国、奥地利和瑞士目前针对视网膜中央静脉阻塞(CRVO)和视网膜分支静脉阻塞(BRVO)所偏好的治疗方法。
针对CRVO和BRVO可用的不同药物、手术和激光治疗方法设计了一份问卷,并发送给德国视网膜协会的成员。
本分析基于124份回收的问卷。我们发现,64%的同事推荐对CRVO患者进行等容血液稀释。分别有32%和27%的受访者认可己酮可可碱输注用于CRVO和BRVO。39%的受访者仅在出现新生血管时才进行全视网膜光凝,而61%的受访者在无可见新生血管时根据缺血程度进行预防性光凝。对于BRVO引起 的黄斑水肿,52%的受访者推荐黄斑格栅光凝。51%的受访者建议对BRVO进行鞘膜切开术,43%的受访者建议对CRVO进行放射状视神经切开术(RON)。分别有58%和56%的受访者对CRVO或BRVO进行玻璃体内注射曲安奈德,2%和3%的受访者进行球周注射曲安奈德。72%的受访者采用玻璃体内抗VEGF治疗,大多数(94%)为此使用贝伐单抗。
德国视网膜协会的成员对CRVO和BRVO患者采用广泛不同的治疗方法。为了制定视网膜静脉阻塞的治疗指南,似乎有必要进行进一步的临床研究以评估不同的治疗选择。