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Therapie: Grundkonzepte

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Entzündliche Augenerkrankungen

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Zusammenfassung

S. Thurau

Die moderne Therapie der Uveitis begann in den fünfziger Jahren mit der oralen und topischen Therapie mit Kortikosteroiden (Gordon and McLean 1950). Später kamen die peri- und intraokularen Applikationsformen dazu. Mit der zunehmenden Kenntnis um die Nebenwirkungen, v. a. bei systemischer Anwendung, wurden steroidsparende Immunsuppressiva eingeführt. Hier stehen vor allem Azathioprin, Methotrexat, Ciclosporin A und die Mycophenolate im Vordergrund. Erst seit Ende der neunziger Jahre wurden auch für die Uveitistherapie zunehmend Biologika wie Interferon-α, TNF (Tumor-Nekrose-Faktor)-Blocker, anti-B-Zell-Antikörper und anti-Interleukin- bzw. anti-Interleukinrezeptor-Antikörper eingesetzt.

Untersuchungen zur Pathogenese der Uveitis ergaben auch Hinweise auf verschiedene bakterielle und virale Erreger. Daraus leiteten sich sehr schnell entsprechende antibiotische bzw. virustatische Therapien ab.

Trotz all dieser Fortschritte stellt eine Uveitis weiterhin eine signifikante Bedrohung des Sehvermögens dar. In den entwickelten Ländern ist sie für etwa 5–20 % der Erblindungen ursächlich (Krumpaszky and Klauss 1996; Suttorp-Schulten and Rothova 1996; Rothova et al. 1996).

Der wesentliche Grund hierfür sind die Nebenwirkungen der zurzeit verfügbaren Medikamente zur Behandlung von Uveitis. Sie begrenzen sowohl die Zeitdauer als auch die Dosierung einer für den Erhalt des Sehvermögens erforderlichen Therapie.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Berlin Charité Campus Virchow-Klinikum, Berlin, Deutschland

    Uwe Pleyer Prof. Dr.

  2. Stadtspital Triemli, Birmensdorferstrasse 497, 8047, Zürich, Schweiz

    Matthias D. Becker Prof. Dr. med. & Stephan Michels PD Dr. med.

  3. Klinik für Augenheilkunde, Charité-Universitätsmedizin Berlin CBF, Hindenburgdamm 30, 12203, Berlin, Deutschland

    Argyrios Chronopoulos Dr. med.

  4. Zentrum für Interdisziplinäre Rheumatologie Stuttgart (ZIRS), Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Deutschland

    Ina Kötter Prof. Dr. med.

  5. Augenklinik Campus Virchow Klinikum, Abteilung für Kinderaugenheilkunde, Strabologie, Neuro-Opththalmologie, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    Daniel J. Salchow Prof. Dr. med.

  6. Augenklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland

    Stephan Thurau Prof. Dr. med.

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    Uwe Pleyer

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Becker, M.D. et al. (2014). Therapie: Grundkonzepte. In: Pleyer, U. (eds) Entzündliche Augenerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38419-6_6

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