Guías de práctica clínica de la SERVTratamiento de la degeneración macular asociada a la edad (DMAE) exudativa

  1. J.M. Ruiz-Moreno
  2. L. Arias-Barquet
  3. F. Armadá-Maresca
  4. A. Boixadera-Espax
  5. A. García-Layana
  6. F. Gómez-Ulla-de-Irazazábal
  7. J. Monés-Carilla
  8. A. Piñero-Bustamante
  9. M. Suárez-de-Figueroa
Revista:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Año de publicación: 2009

Volumen: 84

Número: 7

Páginas: 333-344

Tipo: Artículo

DOI: 10.4321/S0365-66912009000700004 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Archivos de la Sociedad Española de Oftalmologia

Objetivos de desarrollo sostenible

Resumen

Objetivo: La Degeneración Macular Asociada a la Edad (DMAE) en su forma húmeda supone una grave enfermedad que condiciona ceguera legal en muchos pacientes y con mal pronóstico si no es tratada. Pretendemos establecer una guía de actuación clínica con las diferentes opciones terapeúticas que existen en el momento actual, que puedan ayudar al oftalmólogo en su práctica clínica. Métodos: Un grupo de expertos en retina médica seleccionados por la SERV han evaluado los resultados de los diferentes estudios publicados con los fármacos actualmente disponibles, llegando a un consenso basado en la evidencia. Se han establecido unas recomendaciones para el diagnóstico, tratamiento y seguimiento de los enfermos con DMAE húmeda. Resultados: La inyección intravítrea de ranibizumab a la dosis de 0,5 mg permite obtener mejorías significativas de la agudeza visual en lesiones subfoveales, según los datos obtenidos de estudios con máximo nivel de evidencia. Debe ser considerado como el fármaco de primera elección. El empleo de bevacizumab, fármaco sin indicación aprobada para uso intraocular, ni para el tratamiento de la DMAE húmeda, puede aportar un beneficio más próximo a los resultados obtenidos con el ranibizumab que a los obtenidos con la terapia fotodinámica (TFD) y el pegaptanib. El uso de pegaptanib sódico en inyección intravítrea a la dosis de 0,3 mg como tratamiento de lesiones subfoveales permite obtener resultados parecidos a la TFD, pero en un abanico más amplio de lesiones Conclusiones: Los resultados de los estudios basados en la evidencia constituyen una buena guía de actuación en el tratamiento de esta enfermedad.

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