Der Tod - gefürchtet oder ersehnt?

Lebensverlängernde Massnahmen auf der einen, begleiteter Suizid auf der anderen Seite: Mensch und Medizin greifen zunehmend in den Sterbeprozess ein. Wie beeinflussen Glaube und Jenseitsvorstellungen die Haltung zum Lebensende? Amira Hafner-Al Jabaji spricht mit Gästen aus drei Religionen. Die Frage, ob aktive Hilfe zum Suizid erlaubt sein soll, ist ein sensibles Thema. Bisher haben sich von religiöser Seite vor allem christliche Kirchen dazu kritisch vernehmen lassen. Doch wie sieht die Sicht auf den Tod und auf das Sterben in anderen Religionen aus? Was hat den Vorrang im Spannungsfeld von Selbstbestimmung und Schicksal, zwischen Patientenwillen und Gotteswillen, zwischen Möglichem und Wünschbarem am Ende des Lebens? Es diskutieren der muslimische Arzt und Philosoph Ilhan Ilkiliç, die evangelische Theologin und Religionspsychologin Isabelle Noth und der Sozialpädagoge und Zen-Buddhist Marco Röss.

Fluctuations in Pigment Epithelial Detachment and Retinal Fluid Using a Bimonthly Treatment Regimen with Aflibercept for Neovascular Age-Related Macular Degeneration

PURPOSE To assess the effect of a bimonthly treatment regimen with intravitreal aflibercept on retinal fluid and pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (AMD). METHODS Twenty-six treatment-naive eyes of 26 patients with choroidal neovascularisation secondary to AMD were included. The patients received three initial monthly (mean 30 days) intravitreal injections of aflibercept followed by a bimonthly (mean 62 days) fixed regimen for a total of 1 year. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) measurements were recorded at monthly intervals. In addition, the presence of intraretinal fluid (IRF) or subretinal fluid (SRF) or a combination of both as well as serous and fibrovascular PEDs were assessed. RESULTS The mean patient age was 80 years (range 54-93). There were 14 male and 12 female patients. The mean gain in BCVA at 1 year was 9.3 letters (SEM ±3) with a mean reduction of the central retinal thickness of 154 µm (SEM ±50). After 3 monthly injections of aflibercept, there was resolution of IRF and SRF in 80% of the treated eyes; the amount of fluid increased at months 4, 6 and 8 with troughs in between. Whereas fibrovascular PEDs remained stable after the loading phase, serous PEDs displayed a seesaw pattern. Patients without retinal pigment epithelium (RPE) atrophy at the end of the 1-year period had significantly better BCVA compared to patients with RPE atrophy (p = 0.03). CONCLUSION Despite significant overall BCVA gain, bimonthly intervals seem insufficient to maintain the morphological improvements after the initial loading dose with intravitreal aflibercept.