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Keratoconjunctivitis sicca und neurotrophe Keratopathie im Kindesalter

Ursachen und Therapie

Dry eye syndrome and neurotrophic keratitis in childhood

Causes and therapy

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Zusammenfassung

Hintergrund

Hornhauterkrankungen stellen einen wichtigen Bereich in der Kinderophthalmologie dar. Die Pathogenese der Keratoconjunctivitis sicca und der neurotrophen Keratopathie ist auch im Kindesalter komplex: Beide Entitäten können sowohl isoliert als auch im Rahmen von systemischen Erkrankungen auftreten. Die Diagnosestellung erfolgt bei Kindern aufgrund der teilweise erschwerten Untersuchbarkeit häufig verzögert. Bei nicht rechtzeitiger Behandlung kann es zu bleibenden Schäden und Amblyopie kommen.

Methoden

Literaturübersicht über die Pathogenese der Keratoconjunctivitis sicca und neurotrophen Keratopathie im Kindesalter sowie klinische Beispiele aus der kinderophthalmologischen Sprechstunde und Übersicht zur Therapie.

Ergebnisse

Keratoconjunctivitis sicca und neurotrophe Keratopathie sind bei Kindern seltener als bei Erwachsen, zeigen aber ein sehr breites ätiopathologisches Spektrum. Die Kenntnis der Differenzialdiagnosen und die Anwendung kindgerechter Untersuchungstechniken sowie in einigen Fällen eine interdisziplinäre Zusammenarbeit sind wichtig für die frühzeitige Diagnosestellung und die Vermeidung von Komplikationen.

Schlussfolgerung

Keratoconjunctivitis sicca und neurotrophe Keratopathie können bei Kindern leicht übersehen werden, da ihr Vorkommen im Kindesalter teilweise unterschätzt wird und die Untersuchbarkeit bei Kindern häufig reduziert ist.

Abstract

Purpose

The purpose of this review is to enhance the physician’s awareness of dry eye syndrome and neurotrophic keratitis in children, to describe the most frequently associated conditions and to discuss the diagnostic and therapeutic options available.

Methods

A literature review of the pathogenesis of dry eye syndrome and neurotrophic keratitis in children was carried out, clinical cases from our pediatric ophthalmology office are presented as well as therapeutic strategies.

Results

Diseases of the cornea and ocular surface such as dry eye syndrome, neurotrophic keratitis and corneal ulcers are infrequent in children compared to adults. However, they do occur and should be diagnosed and treated as soon as possible in order to prevent long-term complications and amblyopia.

Conclusions

Inflammatory diseases of the ocular surface can be easily overlooked in children due to the often unknown spectrum of differential diagnoses and the frequently reduced cooperation during examination of young children. Correct and early diagnosis is essential for prevention of long-term complications, e.g. corneal ulceration and scarring.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    T. Dietrich, A.B. Renner, H. Helbig & I.M. Oberacher-Velten

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  1. T. Dietrich
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  2. A.B. Renner
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  3. H. Helbig
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  4. I.M. Oberacher-Velten
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Correspondence to T. Dietrich.

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Dietrich, T., Renner, A., Helbig, H. et al. Keratoconjunctivitis sicca und neurotrophe Keratopathie im Kindesalter. Ophthalmologe 107, 911–917 (2010). https://doi.org/10.1007/s00347-010-2238-0

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