Zusammenfassung
Schwere infektiöse Hornhautulzerationen, unter anderem mit herpetischer Genese, führen in der Regel zur deutlichen Beeinträchtigung der Sehschärfe bis hin zur Erblindung. Die Behandlung richtet sich nach der Grunderkrankung und erfordert neben einer breiten medikamentösen Therapie die Entwicklung chirurgischer Strategien zur Wiederherstellung der Integrität der kornealen Augenoberfläche. Herpetisch bedingte persistierende Hornhautepitheldefekte mit oder ohne Ulzeration bis hin zur Entwicklung einer neurotrophen Keratopathie mit dem Risiko der Perforation der Hornhaut stellen immer noch eine klinische Herausforderung in der Ophthalmochirurgie dar. Seit Einführung moderner Konservierungsmethoden Mitte der 1990er-Jahre hat die unter sterilen Bedingungen nach Kaiserschnitt gewonnene innerste Schicht der Plazenta, die Amnionmembran (AM) als Basalmembranersatz eine Renaissance erlebt und ist heute in der rekonstruktiven Chirurgie der Augenoberfläche kaum wegzudenken. Die vielfältigen, mittlerweile etablierten Einsatzmöglichkeiten der AM reichen von einem Transplantat („Graft”), natürlichen Verband („Patch”) bis hin zum Kultursubstrat („Carrier”) für die Ex-vivo-Züchtung von okulärem Oberflächenepithel. In diesem Übersichtsartikel sollen die Grundlagen und die klinische Applikation der Amnionmembrantransplantation (AMT) in der Behandlung von Hornhautinfektionen durch Herpes-Simplex-Virus und Varizella-Zoster-Virus beschrieben werden.
Abstract
Severe infectious corneal ulceration such as herpetic stromal keratitis commonly causes loss of vision and may lead to blindness. Treatment depending on the underlying disease includes antimicrobial medication and the development of surgical strategies to restore the integrity of the corneal ocular surface. Ulcerative herpetic stromal keratitis and/or neurotrophic keratopathy with the risk of corneal perforation are still clinically challenging conditions in ophthalmic surgery of the ocular surface. Since the introduction of newly developed preservation methods, amniotic membrane (AM) functioning as a basement membrane substitute has gained widespread popularity in ocular surface reconstruction. Various ways of clinical application such as the use of AM as a graft, patch or culture substrate and carrier system to expand ocular surface epithelia have been recently reported. In this article, the basis and clinical application of amniotic membrane transplantation for the management of corneal infections with Herpes simplex and Herpes zoster virus are reviewed.
Schlüsselwörter
Amnionmembran - Kornea - herpetische stromale Keratitis - Ulkus
Key words
amniotic membrane - cornea - herpetic stromal keratitis - ulcurs
Literatur
-
1
DeRotth A.
Plastic repair of conjunctival defects with fetal membrane.
Arch Ophthalmol.
1940;
40
522-525
-
2
Lee S H, Tseng S C.
Amniotic membrane transplantation for persistent epithelial defects with ulceration.
Am J Ophthalmol.
1997;
123
303-312
-
3
Prabhasawat P, Barton K, Burkett G et al.
Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision.
Ophthalmology.
1997;
104
974-985
-
4
Kim J C, Tseng S C.
Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas.
Cornea.
1995;
14
473-484
-
5
Meller D, Tseng S C.
Reconstruction of the conjunctival and corneal surface. Transplantation of amnionic membrane.
Ophthalmologe.
1998;
95
805-813
-
6
Tseng S C.
Amniotic membrane transplantation for ocular surface reconstruction.
Biosci Rep.
2001;
21
481-489
-
7
Prabhasawat P, Tseng S C.
Impression cytology study of epithelial phenotype of ocular surface reconstructed by preserved human amniotic membrane.
Arch Ophthalmol.
1997;
115
1360-1367
-
8
Kruse F E, Joussen A M, Rohrschneider K et al.
Cryopreserved human amniotic membrane for ocular surface reconstruction.
Graefes Arch Clin Exp Ophthalmol.
2000;
238
68-75
-
9
Thomasen H, Pauklin M, Steuhl K P et al.
Comparison of cryopreserved and air-dried human amniotic membrane for ophthalmologic applications.
Graefes Arch Clin Exp Ophthalmol.
2009;
247
1691-1700
-
10
Versen-Hoeynck von F, Steinfeld A P, Becker J et al.
Sterilization and preservation influence the biophysical properties of human amnion grafts.
Biologicals.
2008;
36
248-255
-
11
Meller D, Tseng S C.
Conjunctival epithelial cell differentiation on amniotic membrane.
Invest Ophthalmol Vis Sci.
1999;
40
878-886
-
12
Koizumi N J, Inatomi T J, Sotozono C J et al.
Growth factor mRNA and protein in preserved human amniotic membrane.
Curr Eye Res.
2000;
20
173-177
-
13
Kurpakus-Wheater M.
Laminin-5 is a component of preserved amniotic membrane.
Curr Eye Res.
2001;
22
353-357
-
14
Shimmura S, Shimazaki J, Ohashi Y et al.
Antiinflammatory effects of amniotic membrane transplantation in ocular surface disorders.
Cornea.
2001;
20
408-413
-
15
Solomon A, Rosenblatt M, Monroy D et al.
Suppression of interleukin 1alpha and interleukin 1beta in human limbal epithelial cells cultured on the amniotic membrane stromal matrix.
Br J Ophthalmol.
2001;
85
444-449
-
16
Ueta M, Kweon M N, Sano Y et al.
Immunosuppressive properties of human amniotic membrane for mixed lymphocyte reaction.
Clin Exp Immunol.
2002;
129
464-470
-
17
Heiligenhaus A, Li H, Hernandez Galindo E E et al.
Management of acute ulcerative and necrotising herpes simplex and zoster keratitis with amniotic membrane transplantation.
Br J Ophthalmol.
2003;
87
1215-1219
-
18
Shi W Y, Chen M, Wang F H et al.
Multilayer amniotic membrane transplantation for treatment of necrotizing herpes simplex stromal keratitis.
Zhonghua Yan Ke Za Zhi.
2005;
41
1107-1111
-
19
Heiligenhaus A, Bauer D, Meller D et al.
Improvement of HSV-1 necrotizing keratitis with amniotic membrane transplantation.
Invest Ophthalmol Vis Sci.
2001;
42
1969-1974
-
20
Hao Y, Ma D H, Hwang D G et al.
Identification of antiangiogenic and antiinflammatory proteins in human amniotic membrane.
Cornea.
2000;
19
348-352
-
21
Park W C, Tseng S C.
Modulation of acute inflammation and keratocyte death by suturing, blood, and amniotic membrane in PRK.
Invest Ophthalmol Vis Sci.
2000;
41
2906-2914
-
22
Heiligenhaus A, Li H, Yang Y et al.
Amniotic membrane transplantation improves experimental herpetic keratitis. Modulation of matrix metalloproteinase-9.
Ophthalmologe.
2004;
101
59-65
-
23
Bauer D, Wasmuth S, Hermans P et al.
On the influence of neutrophils in corneas with necrotizing HSV-1 keratitis following amniotic membrane transplantation.
Exp Eye Res.
2007;
85
335-345
-
24
Bauer D, Wasmuth S, Hennig M et al.
Amniotic membrane transplantation induces apoptosis in T lymphocytes in murine corneas with experimental herpetic stromal keratitis.
Invest Ophthalmol Vis Sci.
2009;
50
3188-3198
-
25
He H, Li W, Chen S Y et al.
Suppression of activation and induction of apoptosis in RAW264.7 cells by amniotic membrane extract.
Invest Ophthalmol Vis Sci.
2008;
49
4468-4475
-
26
Meller D, Pires R T, Mack R J et al.
Amniotic membrane transplantation for acute chemical or thermal burns.
Ophthalmology.
2000;
107
980-989
; discussion 990
-
27
Shammas M C, Lai E C, Sarkar J S et al.
Management of acute Stevens-Johnson syndrome and toxic epidermal necrolysis utilizing amniotic membrane and topical corticosteroids.
Am J Ophthalmol.
2010;
149
203-213 e202
-
28
Sippel K C, Ma J J, Foster C S.
Amniotic membrane surgery.
Curr Opin Ophthalmol.
2001;
12
269-281
-
29
Seitz B, Gruterich M, Cursiefen C et al.
Conservative and surgical treatment of neurotrophic keratopathy.
Ophthalmologe.
2005;
102
15-26
-
30
Seitz B.
Amniotic membrane transplantation. An indispensable therapy option for persistent corneal epithelial defects.
Ophthalmologe.
2007;
104
1075-1079
-
31
John T, Foulks G N, John M E et al.
Amniotic membrane in the surgical management of acute toxic epidermal necrolysis.
Ophthalmology.
2002;
109
351-360
-
32
Meller D, Pires R T, Tseng S C.
Ex vivo preservation and expansion of human limbal epithelial stem cells on amniotic membrane cultures.
Br J Ophthalmol.
2002;
86
463-471
-
33
Seitz B, Das S, Sauer R et al.
Amniotic membrane transplantation for persistent corneal epithelial defects in eyes after penetrating keratoplasty.
Eye.
2009;
23
840-848
-
34
Kruse F E, Rohrschneider K, Volcker H E.
Multilayer amniotic membrane transplantation for reconstruction of deep corneal ulcers.
Ophthalmology.
1999;
106
1504-1510
; discussion 1511
-
35
Shi W, Chen M, Xie L.
Amniotic membrane transplantation combined with antiviral and steroid therapy for herpes necrotizing stromal keratitis.
Ophthalmology.
2007;
114
1476-1481
-
36
Knickelbein J E, Hendricks R L, Charukamnoetkanok P.
Management of herpes simplex virus stromal keratitis: an evidence-based review.
Surv Ophthalmol.
2009;
54
226-234
-
37
Spelsberg H, Reichelt J A.
Amniotic membrane transplantation in proven ulcerative herpetic keratitis: successful anti-inflammatory treatment in time.
Klin Monbl Augenheilkd.
2008;
225
75-79
-
38
Fuchsluger T, Tuerkeli E, Westekemper H et al.
Rate of epithelialisation and re-operations in corneal ulcers treated with amniotic membrane transplantation combined with botulinum toxin-induced ptosis.
Graefes Arch Clin Exp Ophthalmol.
2007;
245
955-964
-
39
Ferreira De Souza R, Hofmann-Rummelt C, Kruse F E et al.
Multilayer amniotic membrane transplantation for corneal ulcers not treatable by conventional therapy – a prospective study of the status of cornea and graft during follow-up.
Klin Monbl Augenheilkd.
2001;
218
528-534
-
40
Seitz B, Kruse F E.
Neurotrophic keratitis. Problem child among corneal diseases.
Ophthalmologe.
2005;
102
5-6
-
41
Bonini S, Lambiase A, Rama P et al.
Topical treatment with nerve growth factor for neurotrophic keratitis.
Ophthalmology.
2000;
107
1347-1351
; discussion 1351 – 1342
-
42
Lambiase A, Manni L, Bonini S et al.
Nerve growth factor promotes corneal healing: structural, biochemical, and molecular analyses of rat and human corneas.
Invest Ophthalmol Vis Sci.
2000;
41
1063-1069
-
43
You L, Kruse F E, Volcker H E.
Neurotrophic factors in the human cornea.
Invest Ophthalmol Vis Sci.
2000;
41
692-702
-
44
Marfurt C F, Murphy C J, Florczak J L.
Morphology and neurochemistry of canine corneal innervation.
Invest Ophthalmol Vis Sci.
2001;
42
2242-2251
-
45
Nagano T, Nakamura M, Nakata K et al.
Effects of substance P and IGF-1 in corneal epithelial barrier function and wound healing in a rat model of neurotrophic keratopathy.
Invest Ophthalmol Vis Sci.
2003;
44
3810-3815
-
46
Nakamura M, Kawahara M, Nakata K et al.
Restoration of corneal epithelial barrier function and wound healing by substance P and IGF-1 in rats with capsaicin-induced neurotrophic keratopathy.
Invest Ophthalmol Vis Sci.
2003;
44
2937-2940
-
47
Gris O, Guell J L, Lopez-Navidad A et al.
Application of the amniotic membrane in ocular surface pathology.
Ann Transplant.
1999;
4
82-84
-
48
Prabhasawat P, Tesavibul N, Komolsuradej W.
Single and multilayer amniotic membrane transplantation for persistent corneal epithelial defect with and without stromal thinning and perforation.
Br J Ophthalmol.
2001;
85
1455-1463
-
49
Chen H J, Pires R T, Tseng S C.
Amniotic membrane transplantation for severe neurotrophic corneal ulcers.
Br J Ophthalmol.
2000;
84
826-833
-
50
Schroeder A, Theiss C, Steuhl K P et al.
Effects of the human amniotic membrane on axonal outgrowth of dorsal root ganglia neurons in culture.
Curr Eye Res.
2007;
32
731-738
-
51
Touhami A, Grueterich M, Tseng S C.
The role of NGF signaling in human limbal epithelium expanded by amniotic membrane culture.
Invest Ophthalmol Vis Sci.
2002;
43
987-994
-
52
Tseng S C, Tsubota K.
Important concepts for treating ocular surface and tear disorders.
Am J Ophthalmol.
1997;
124
825-835
Prof. Dr. Daniel Meller
Zentrum für Augenheilkunde, Klinik für Erkrankungen des vorderen Augenabschnitts, Universität Duisburg-Essen
Hufelandstraße 55
45122 Essen
Telefon: ++ 49/7 23/8 43 82
Fax: ++ 49/7 23/56 45
eMail: Daniel.Meller@uk-essen.de
