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Klin Monbl Augenheilkd 2016; 6(01): 71-86
DOI: 10.1055/s-0041-111285
Bindehaut, Hornhaut, Lederhaut
Georg Thieme Verlag KG Stuttgart · New York

Nicht infektiöse Bindehauterkrankungen

Teil 1: AutoimmunkonjunktivitidenNon-Infectious Conjunctiva Diseases. Part 1: Autoimmune Conjunctivitides
T. Meyer-ter-Vehn
Klinik und Poliklinik für Augenheilkunde, Universität Würzburg
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Publication History

Publication Date:
15 February 2016 (online)

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See also:

Nicht infektiöse BindehauterkrankungenAugenheilkunde up2date 2016; 6(02): 137-154
DOI: 10.1055/s-0042-102334

See also:

Nicht infektiöse BindehauterkrankungenKlin Monbl Augenheilkd 2016; 233(04): 547-564
DOI: 10.1055/s-0033-1358217

Autoimmunreaktionen im Bereich der Augenoberfläche umfassen sowohl allergische Erkrankungen als auch durch autoreaktive T-Zellen bzw. zirkulierende Autoantikörper verursachte Krankheiten. Zu Letzteren zählen u. a.

  • das okuläre Schleimhautpemphigoid,

  • Augenbeteiligungen bei Stevens-Johnson-Syndrom
    sowie

  • die okuläre Graft versus Host Disease (GvHD).

Gekennzeichnet sind alle 3 Erkrankungen durch eine autoimmunvermittelte Entzündung der Konjunktiva und des subkonjunktivalen Gewebes mit nachfolgender Vernarbungsreaktion. Am stärksten ist diese oft beim okulären Schleimhautpemphigoid ausgeprägt. Durch die oft lang anhaltende Entzündungsreaktion kommt es zur strukturellen Schädigung der Konjunktiva sowie der gesamten Augenoberfläche mit Keratopathie, Beteiligung der Lider, der Tränendrüse und Tränenwege.

 

  • Literatur

  • 1 Oyama N, Setterfield JF, Powell AM et al. Bullous pemphigoid antigen II (BP180) and its soluble extracellular domains are major autoantigens in mucous membrane pemphigoid: the pathogenic relevance to HLA class II alleles and disease severity. Br J Dermatol 2006; 154: 90-98
    CrossrefGoogle Scholar
  • 2 Ahmed AR, Hombal SM. Cicatricial pemphigoid. Int J Dermatol 1986; 25: 90-96
    CrossrefGoogle Scholar
  • 3 Balding SD, Prost C, Diaz LA et al. Cicatricial pemphigoid autoantibodies react with multiple sites on the BP180 extracellular domain. J Invest Dermatol 1996; 106: 141-146
    CrossrefGoogle Scholar
  • 4 Schmidt E, Zillikens D. Autoimmune and inherited subepidermal blistering diseases: advances in the clinic and the laboratory. Adv Dermatol 2000; 16: 113-157 discussion 158
    Google Scholar
  • 5 Elder MJ, Bernauer W, Leonard J et al. Progression of disease in ocular cicatricial pemphigoid. Br J Ophthalmol 1996; 80: 292-296
    CrossrefPubMedGoogle Scholar
  • 6 Elder MJ, Bernauer W. Monitoring of activity and progression in cicatrising conjunctivitis. Dev Ophthalmol 1997; 28: 111-122
    Google Scholar
  • 7 Rowsey JJ, Macias-Rodriguez Y, Cukrowski C. A new method for measuring progression in patients with ocular cicatricial pemphigoid. Arch Ophthalmol 2004; 122: 179-184
    CrossrefGoogle Scholar
  • 8 Chan LS. Mucous membrane pemphigoid. Clin Dermatol 2001; 19: 703-711
    CrossrefGoogle Scholar
  • 9 Chan LS, Ahmed AR, Anhalt GJ et al. The first international consensus on mucous membrane pemphigoid: definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators. Arch Dermatol 2002; 138: 370-379
    CrossrefPubMedGoogle Scholar
  • 10 Neff AG, Turner M, Mutasim DF. Treatment strategies in mucous membrane pemphigoid. Ther Clin Risk Manag 2008; 4: 617-626
    CrossrefPubMedGoogle Scholar
  • 11 Knudson RM, Kalaaji AN, Bruce AJ. The management of mucous membrane pemphigoid and pemphigus. Dermatol Ther 2010; 23: 268-280
    CrossrefGoogle Scholar
  • 12 Foster CS. Cicatricial pemphigoid. Trans Am Ophthalmol Soc 1986; 84: 527-663
    Google Scholar
  • 13 Tauber J, Sainz de la Maza M, Foster CS. Systemic chemotherapy for ocular cicatricial pemphigoid. Cornea 1991; 10: 185-195
    CrossrefGoogle Scholar
  • 14 Saw VP, Dart JK, Rauz S et al. Immunosuppressive therapy for ocular mucous membrane pemphigoid strategies and outcomes. Ophthalmology 2007; 115: 253-261.e1
    Google Scholar
  • 15 Letko E, Miserocchi E, Daoud YJ et al. A nonrandomized comparison of the clinical outcome of ocular involvement in patients with mucous membrane (cicatricial) pemphigoid between conventional immunosuppressive and intravenous immunoglobulin therapies. Clin Immunol 2004; 111: 303-310
    CrossrefGoogle Scholar
  • 16 Schmidt E, Hunzelmann N, Zillikens D et al. Rituximab in refractory autoimmune bullous diseases. Clin Exp Dermatol 2006; 31: 503-508
    CrossrefGoogle Scholar
  • 17 Poon AC, Geerling G, Dart JK et al. Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol 2001; 85: 1188-1197
    CrossrefGoogle Scholar
  • 18 Soong HK, Martin NF, Wagoner MD et al. Topical retinoid therapy for squamous metaplasia of various ocular surface disorders. A multicenter, placebo-controlled double-masked study. Ophthalmology 1988; 95: 1442-1446
    CrossrefGoogle Scholar
  • 19 Elder MJ, Collin JRO. Lid surgery: The management of cicatricial entropion and trichiasis. In: Bernauer W, Dart JKG, Elder MJ, eds Cicatrising conjunctivitis. Developments in Ophthalmology, vol 28. Basel: Karger; 1997: 207-218
    CrossrefGoogle Scholar
  • 20 Elder MJ, Bernauer W. Cryotherapy for trichiasis in ocular cicatricial pemphigoid. In: Developments in Ophthalmology. Br J Ophthalmol 1994; 78: 769-771
    CrossrefGoogle Scholar
  • 21 Heiligenhaus A, Shore JW, Rubin PA et al. Long-term results of mucous membrane grafting in ocular cicatricial pemphigoid. Implications for patient selection and surgical considerations. Ophthalmology 1993; 100: 1283-1288
    CrossrefGoogle Scholar
  • 22 Tugal-Tutkun I, Akova YA, Foster CS. Penetrating keratoplasty in cicatrizing conjunctival diseases. Ophthalmology 1995; 102: 576-585
    CrossrefGoogle Scholar
  • 23 Samson CM, Nduaguba C, Baltatzis S et al. Limbal stem cell transplantation in chronic inflammatory eye disease. Ophthalmology 2002; 109: 862-868
    CrossrefGoogle Scholar
  • 24 Hille K, Grabner G, Liu C et al. Standards for modified osteoodontokeratoprosthesis (OOKP) surgery according to Strampelli and Falcinelli: the Rome-Vienna Protocol. Cornea 2005; 24: 895-908
    CrossrefGoogle Scholar
  • 25 Palioura S, Kim B, Dohlman CH et al. The Boston keratoprosthesis type I in mucous membrane pemphigoid. Cornea 2013; 32: 956-961
    CrossrefGoogle Scholar
  • 26 Geerling G, Dart JK. Management and outcome of cataract surgery in ocular cicatricial pemphigoid. Graefes Arch Clin Exp Ophthalmol 2000; 238: 112-118
    CrossrefGoogle Scholar
  • 27 Borchers AT, Lee JL, Naguwa SM et al. Stevens-Johnson syndrome and toxic epidermal necrolysis. Autoimmun Rev 2008; 7: 598-605
    CrossrefGoogle Scholar
  • 28 Raviglione MC, Pablos-Mendez A, Battan R. Clinical features and management of severe dermatological reactions to drugs. Drug Saf 1990; 5: 39-64
    CrossrefGoogle Scholar
  • 29 John T, Foulks GN, John ME et al. Amniotic membrane in the surgical management of acute toxic epidermal necrolysis. Ophthalmology 2002; 109: 351-360
    CrossrefGoogle Scholar
  • 30 Araki Y, Sotozono C, Inatomi T et al. Successful treatment of Stevens-Johnson syndrome with steroid pulse therapy at disease onset. Am J Ophthalmol 2009; 147: 1004-1011 1011.e1
    CrossrefGoogle Scholar
  • 31 Shikari H, Antin JH, Dana R. Ocular graft-versus-host disease: a review. Surv Ophthalmol 2013; 58: 233-251
    CrossrefGoogle Scholar
  • 32 Jabs DA, Wingard J, Green WR et al. The eye in bone marrow transplantation. III. Conjunctival graft-vs-host disease. Arch Ophthalmol 1989; 107: 1343-1348
    CrossrefGoogle Scholar
  • 33 Stevenson W, Shikari H, Saboo US et al. Bilateral corneal ulceration in ocular graft-versus-host disease. Clin Ophthalmol 2013; 7: 2153-2158
    Google Scholar
  • 34 Kim RY, Anderlini P, Naderi AA et al. Scleritis as the initial clinical manifestation of graft-versus-host disease after allogenic bone marrow transplantation. Am J Ophthalmol 2002; 133: 843-845
    CrossrefGoogle Scholar
  • 35 Filipovich AH, Weisdorf D, Pavletic S et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 2005; 11: 945-956
    CrossrefGoogle Scholar
  • 36 Jacobs R, Tran U, Chen H et al. Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria. Bone Marrow Transplant 2012; 47: 1470-1473
    CrossrefGoogle Scholar
  • 37 Ogawa Y, Kim SK, Dana R et al. International Chronic Ocular Graft-vs-Host-Disease (GVHD) Consensus Group: proposed diagnostic criteria for chronic GVHD (Part I). Sci Rep 2013; 3: 3419
    CrossrefPubMedGoogle Scholar
  • 38 Schargus M, Meyer-ter-Vehn T, Menrath J et al. Correlation between tear film osmolarity and the disease score of the international chronic ocular graft-versus-host-disease consensus group in hematopoietic stem cell transplantation patients. Cornea 2015; 34: 911-916
    CrossrefGoogle Scholar
  • 39 Jabs DA, Hirst LW, Green WR et al. The eye in bone marrow transplantation. II. Histopathology. Arch Ophthalmol 1983; 101: 585-590
    CrossrefGoogle Scholar
  • 40 Wang Y, Ogawa Y, Dogru M et al. Baseline profiles of ocular surface and tear dynamics after allogeneic hematopoietic stem cell transplantation in patients with or without chronic GVHD-related dry eye. Bone Marrow Transplant 2010; 45: 1077-1083
    CrossrefGoogle Scholar
  • 41 Ogawa Y, Okamoto S, Mori T et al. Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease. Bone Marrow Transplant 2003; 31: 579-583
    CrossrefGoogle Scholar
  • 42 Dietrich-Ntoukas T, Cursiefen C, Westekemper H et al. Diagnosis and treatment of ocular chronic graft-versus-host disease: report from the German-Austrian-Swiss Consensus Conference on Clinical Practice in chronic GVHD. Cornea 2012; 31: 299-310
    CrossrefPubMedGoogle Scholar