Das Trockene Auge

Zusammenfassung

Das Trockene Auge beim Sjögren Syndrom ist eine Erkrankung, die zu stark beeinträchtigenden Symptomen sowie Hornhautkomplikationen verbunden mit Sehminderung führen kann. Die autoimmune Entzündung der Tränendrüse und der Augenoberfläche spielt sicher die wichtigste pathogenetische Rolle. Zudem werden hormonelle Veränderungen sowie neuronale Störungen in der Pathogenese diskutiert. Die Therapie besteht aus symptomatischen Maßnahmen (Schutzbrillen, Luftbefeuchter), der Beseitigung von Lidanomalien, der Behandlung einer assoziierten Blepharitis, der Implantation von punctum plugs sowie im Absetzen bzw. Umsetzen bestimmter Medikamente. Neben einer Vielzahl von Tränenersatzprodukten mit unterschiedlichen Wirk- und Zusatzstoffen sowie autologem Serum stehen heute im Ansatz kausale Medikamente zur Verfügung wie lokale Kortikosteroide, topisches Ciclosporin A, orale (M1)/M3-Agonisten und intravenöse anti-CD20 monoklonale Antikörper (Rituximab). Lokale Androgene und Sekretagoga sind in klinischer Erprobung.

Abstract

Dry eye syndrome in patients with Sjögren's syndrome is typically associated with severe subjective symptoms, and may lead to corneal complications and visual loss. Autoimmune inflammation of the tear gland and the ocular surface as well as hormonal factors and a neuronal dysregulation are discussed as the main pathogenetic factors involved. Therapy includes safety goggles, humidifiers, correction of lid anomalies, treatment of associated blepharitis, punctum plugs, and the discontinuance of specific medications. Besides numerous artificial tears with various ingredients, and autologous serum, treatment options targeting basic disease mechanisms such as topical steroids and cyclosporin A, oral muscarinic agonists as well as intravenous anti-CD20 monoclonal antibodies (Rituximab) are available. Topical androgens and secretagogues are currently undergoing clinical studies to evaluate their efficacy in the treatment of dry eye.

Schlüsselwörter

Trockenes Auge - Blepharitis - Sjögren Syndrom - Autoimmunerkrankung - Konservierungsstoffe

Key words

dry eye syndrome - blepharitis - Sjögren's syndrome - autoimmune disease - preservatives

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