Augenbeteiligung bei ausgewählten rheumatischen Erkrankungen – Klinik im Erwachsenenalter

Zusammenfassung

Okuläre Manifestationen rheumatischer Erkrankungen sind häufig und tragen wesentlich zur Morbidität und Reduktion der Lebensqualität der betroffenen Patienten bei. Die Kenntnis über typische Manifestationsformen ist bedeutsam für den Rheumatologen, um Patienten mit entsprechender Symptomatik frühzeitig ophthalmologisch vorstellen zu können oder auch regelmäßige Screeninguntersuchungen zu veranlassen (z. B. bei Behçet-Syndrom). Umgekehrt ist eine (ggf. auch dringliche) rheumatologische Mitbeurteilung bei bestimmten ophthalmologischen Krankheitsbildern entscheidend, um eine (u. U. letale) systemische assoziierte Erkrankung nicht zu übersehen. Patienten mit rheumatischen bzw. entzündlichen okulären Erkrankungen sollten immer durch den behandelnden Arzt über mögliche Symptome anderweitiger Organmanifestationen aufgeklärt werden, um eine verzögerte Diagnosestellung zu vermeiden. „Klassische“ Assoziationen für Uveitiden sind die (HLA-B27-assoziierten) Spondyloarthritiden und die akute anteriore Uveitis sowie die retinale Vaskulitis mit oder ohne Panuveitis und das Behçet-Syndrom. Bei Patienten mit rheumatoider Arthritis oder ANCA-assoziierten Vaskulitiden hingegen treten typischerweise Skleritiden (mit oder ohne periphere ulzerative Keratitis) auf, aber auch eine Vielzahl weiterer Befunde ist möglich. Die enge interdisziplinäre Zusammenarbeit insbesondere in der Therapiegestaltung ist entscheidend, um eine gute Prognose für den Patienten zu sichern.

Schlüsselwörter

rheumatische Erkrankungen - Uveitis - Skleritis - rheumatoide Arthritis - Spondyloarthritis - Vaskulitis

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