104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
FR.03.01 Significance of submacular surgery in age related macular degeneration Kirchhof B.
Zentrum für Augenheilkunde, Universität zu Köln 60% of visually disabled from age related macular degeneration (AMD) who see 0.3 and less are confronted by the exsudative form of AMD. Recently VEGF antagonists improved the prognosis for these patients. Intravitreal Injection of VEGF Antagonists has a relatively low risk profile and usually stabilizes if not improves vision. Similar success by submacular surgery is possible but associated with considerable surgical risk. Vitreo-retinal surgeons uniformly support the preference of intravitreally applied VEGF antagonists. A surgical approach however is still conceivable in submacular haemorrhage, in ruptures of the pigment epithelium with retraction of the RPE beyond the fovea, and in geographic atrophy. Indications to treat need readjustments: A) Exsudative AMD of any kind: VEGF antagonists, eventually in combination with photodynamic therapy. B) Fresh submacular haemorrhage limited to the macula: intravitreal rTPA with gas, followed by VEGF antagonist. C) Fresh massive submacular haemorrhage: surgical removal of blood combined with macular translocation or RPE sheet transplant, or VEGF antagonist. D) Progressive dry AMD with imminent loss of reading vision: RPE sheet transplant (experimental procedure).
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