Neue Entwicklungen in der Therapie der altersabhängigen Makuladegeneration

Age-related macular degeneration is the commonest cause for registration of blindness in developed countries. Epidemiological data indicate that there are 4.5 million patients affected in Germany with both prevalence and incidence increasing steadily, with considerable economic implications. Late manifestations of the disease result in inability to read and to perform activities of daily living. Efficacious prophylactic and therapeutic measures to prevent irreversible loss of central vision are urgently needed. Based on a better understanding of the underlying molecular mechanisms new therapeutic approaches have recently been proposed which build on previous approaches such as thermal laser surgery or photodynamic therapy. Repeated intravitreal injection of anti-VEGF (vascular endothelial growth factor) agents have a beneficial effect on visual decline, growth and permeability of neovascular membranes. Microsurgical procedures include excision of areas of choroidal neovascularization with consecutive displacement of the over-lying neurosensory retina or autologous pigment epithelial translocation.