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Chorioiditis

Choroiditis

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Zusammenfassung

Bei der Aderhautentzündung (Chorioiditis) handelt es sich um keine einheitliche Erkrankung, sondern um einen Oberbegriff für verschiedene seltene klinische Entitäten – Entzündungsprozesse, die von der Aderhaut ausgehen und sekundär andere Strukturen betreffen. Mit der Indozyaningrünangiographie konnten Einblicke in die Pathogenese gewonnen werden, die Basis einer Einteilung wurde. Man unterscheidet primäre Entzündungen der Choriokapillaris und des Stromas sowie sekundäre Stromaentzündungen, bei denen die tiefe Aderhaut zufällig im Rahmen von Systemerkrankungen beteiligt ist. Ätiologisch liegt den meisten Formen eine Autoimmunität zugrunde, wobei seit einigen Jahren aufgrund des verbesserten Erregernachweises zunehmend infektiöse Ursachen detektiert werden. Die Therapie ist meist antientzündlich-immunsuppressiv zum Visuserhalt. Bei nachgewiesenen Infektionen kommen Antibiotika zum Einsatz. Bei einigen wenigen Chorioiditisformen ist die Prognose auch ohne Therapie gut. Im vorliegenden Beitrag werden die einzelnen Entitäten der Chorioiditis, die Differenzialdiagnose und die Grundzüge der Therapie dargestellt.

Abstract

Choroiditis is not a homogenous disease, but rather an umbrella term for a number of rare clinical entities or inflammatory processes beginning in the choroid, which may secondarily involve neighboring structures. Indocyanine green angiography has afforded insight into the pathogenesis of this disease, which has formed the basis for a classification. Primary inflammation of the choriocapillaris and choroidal stroma is differentiated from secondary stromal inflammation, in which the choroid has accidentally become the site of inflammation in the course of a systemic disease. In most cases the etiology is autoimmunity, but with modern and more sensitive diagnostic tools also infectious etiologies have increasingly been identified. Treatment to preserve visual acuity is usually anti-inflammatory and immunosuppressive, while antibiotic regimens are used in cases of proven infection. Certain specific entities have a good prognosis even without treatment. This article summarizes the different entities of choroiditis, their differential diagnosis and the main treatment principles.

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Abbreviations

AIBSE:

„Acute idiopathic blind spot enlargement“

APMPPE:

Akute posteriore multifokale plakoide Pigmentepitheliopathie

AZOOR:

„Acute zonal occult outer retinopathy“

CNV:

Chorioidale Neovaskularisation

ERG:

Elektroretinogramm

FA:

Fluoresceinangiographie

HLA:

Humanes Leukozytenantigen

ICG:

Indozyaningrün

ICGA:

Indozyaningrünangiographie

MEWDS:

„Multiple evanescent white dot syndrome“

MFC:

Multifokale Chorioiditis

PIC:

„Punctuate inner choroiditis“

POHS:

„Presumed ocular histoplasmosis syndrome“

SO:

Sympathische Ophthalmopathie

VKH:

Vogt-Koyanagi-Harada-Syndrom

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  1. Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstraße 8, 80336, München, Deutschland

    S. Thurau & G. Wildner

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  1. S. Thurau
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  2. G. Wildner
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Correspondence to S. Thurau.

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Thurau, S., Wildner, G. Chorioiditis. Ophthalmologe 107, 79–93 (2010). https://doi.org/10.1007/s00347-009-2116-9

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