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Klin Monbl Augenheilkd 2012; 229(5): 500-505
DOI: 10.1055/s-0031-1299519
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Antientzündliche Therapie beim Trockenen Auge

Anti-Inflammatory Treatment in Dry Eye Disease
P. Steven
  Zentrum für Augenheilkunde, Uniklinik Köln
,
C. Cursiefen
  Zentrum für Augenheilkunde, Uniklinik Köln
› Author Affiliations
Further Information

Publication History

13 February 2012

02 March 2012

Publication Date:
16 May 2012 (online)

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Zusammenfassung

In der Pathogenese des Trockenen Auges spielt neben der Tränenfilminstabilität und dem Tränenmangel mit Anstieg der Osmolarität vor allem die Entzündung der Augenoberfläche eine entscheidende Rolle. Mittlerweile sind zahlreiche Signalwege, sowie azelluläre und zelluläre Faktoren identifiziert worden, die in einem komplexen System vor allem eine autoreaktive Entzündungsreaktion begünstigen und unterhalten können. Da sich diese autoreaktive Immunreaktion unabhängig vom ursprünglichen Auslöser verselbstständigen kann, ist eine Entzündungsinhibition in der Behandlung des Trockenen Auges essenziell. Derzeit zur Verfügung stehende Wirkstoffe wie Steroide, Ciclosporin A, Antibiotika, Omega-3- und -6-Fettsäuren, etc. weisen alle funktionelle oder rechtliche Limitierungen auf, die eine standardisierte Anwendung erschweren. Antilymphangiogene Substanze haben darüber hinaus das Potenzial, bislang verfügbaren Therapiestrategien zu ergänzen und zu verbessern. Unabhängig von jeder antientzündlichen Therapie ist eine detaillierte Untersuchung jedes Patienten essenziell, da die Komplexität des Krankheitsbild eine individuelle Therapieplanung mit Kombination verschiedener Therapeutika erfordert.

Abstract

Dry-eye is a multifactorial disease consisting of different pathomechanisms including instability of the tearfilm, increase of tearfilm osmolarity and most importantly inflammation of the ocular surface. In this context numerous signalling pathways and related immune mechanisms were identified all pointing towards autoimmune reactions as key parameters within this complex system. As autoimmunity tends to act independently from regulatory mechanisms, inhibition of related inflammatory processes is crucial in dry-eye therapy. Currently therapeutic agents such as steroids, cyclosporin, antibiotics, omega-3 and -6 fatty acids, etc. are available and readily used in daily practice. However, these therapies possess functional or legal restrictions that may limit their application. New strategies such as anti-lymphangiogenic therapies may have the potential to substitute or enhance current treatments. Independent of any anti-inflammatory therapy a detailed examination of the individual patient is necessary due to the complexity of the disease to provide individual and successful treatment.

Schlüsselwörter

Bindehaut - Kornea - Pharmakologie - Trockenes Auge - Entzündung

Key words

conjunctiva - cornea - pharmacology - dry eye - inflammation
 

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