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Klin Monbl Augenheilkd 2019; 236(10): 1235-1250
DOI: 10.1055/a-0972-4644
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Georg Thieme Verlag KG Stuttgart · New York

Sterile Keratitis

Sterile Keratitis
Elisabeth M. Messmer
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Publication History

Publication Date:
14 August 2019 (online)

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Zusammenfassung

Sterile Keratitiden können als rein okuläres Problem, aber auch im Rahmen einer potenziell letalen Grunderkrankung auftreten. Diagnosestellung und Management dieser Erkrankung sind eine große Herausforderung für den Augenarzt. Neben therapeutischen Grundprinzipien für alle nicht infektiösen Keratitiden und Ulzerationen bestimmt die jeweilige Pathogenese die spezifische, u. U. lebensrettende Behandlung. Daher muss vor jeder Therapie eine akkurate, wegweisende Diagnose stehen.

Abstract

Sterile keratitis shows multiple manifestations. It may occur as an ophthalmological problem but can also be part of a systemic disease, including potentially lethal systemic vasculitis. Diagnosis as well as management of this disease is a challenging task for the ophthalmologist. There are therapeutic principles which apply to all non-infectious cases of keratitis and corneal ulcerations. Specific treatments, however, are determined by the pathogenesis and may differ. Therefore, an accurate diagnosis must guide therapeutic decision making. The correct diagnosis and management of sterile ulcerative keratitis is able to restore the patientʼs vision in most cases. In potentially lethal systemic disease it may even be able to save the patientʼs life.

Kernaussagen

  • Sterile Keratitiden haben eine Vielzahl sehr unterschiedlicher Ursachen. Sie können als rein okuläres Problem, aber auch als Symptom einer Grunderkrankung, z. B. einer potenziell letalen systemischen Vaskulitis auftreten.

  • Nicht nur die Diagnosestellung, auch das Management dieser Erkrankung ist eine große Herausforderung für den Augenarzt.

  • Es gibt zwar therapeutische Grundprinzipien, die für alle nicht infektiösen Keratitiden und Ulzerationen gelten, die spezifische Behandlung wird jedoch durch die jeweilige Pathogenese bestimmt und kann sehr verschieden sein. Daher muss vor jeder therapeutischen Intervention eine akkurate, wegweisende Diagnose stehen.

  • Die korrekte Diagnose und Therapie einer sterilen ulzerativen Keratitis kann zumeist den Visus wiederherstellen und das Auge erhalten, bei potenziell letalen Grunderkrankungen sogar das Leben des Patienten retten.

Schlüsselwörter

periphere ulzerative Keratitis - okuläre Allergie - neurotrophe Keratopathie - interstitielle Keratitis - diffuse lamelläre Keratitis

Key words

peripheral ulcerative keratitis - ocular allergy - neurotrophic keratopathy - interstitial keratitis - diffuse lamellar keratitis
 

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