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Glaukom und Uveitis

Ursachen und Therapieoptionen bei Augeninnendrucksteigerung im Rahmen entzündlicher Augenerkrankungen

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Zusammenfassung

Das uveitische Sekundärglaukom ist eines der schwierigsten differenzialdiagnostischen und therapeutischen Probleme auf dem Sektor der klinischen Glaukomatologie. Die Prävalenz des Glaukoms unter Uveitispatienten liegt zwischen 5 und 20% mit starken Schwankungen in Abhängigkeit von der Grunderkrankung, Dauer der Erkrankung und Alter der Patienten. Auf der Basis der Spaltlampenuntersuchung kann eine Einteilung der Uveitiden in granulomatöse und nichtgranulomatöse getroffen werden. Die Auswirkungen eines uveitischen Glaukoms auf die Lebensqualität und auf die zentrale Sehschärfe sind insbesondere im Kindesalter gravierend. Die operative Augendrucksenkung sollte beim uveitischen Sekundärglaukom erst dann erfolgen, wenn die medikamentöse Behandlung der Grunderkrankung bzw. der okulären Entzündung allein nicht zur Senkung des Augendruckniveaus ausreicht und die Höhe des Augeninnendrucks unter Berücksichtigung einer schon bestehenden glaukomatösen Sehnervschädigung eine drastische, medikamentös nicht erreichbare Drucksenkung erforderlich macht.

Abstract

Uveitic secondary glaucoma poses one of the most difficult problems for differential diagnostics and therapeutics in the field of clinical glaucomatology. The prevalence of glaucoma among uveitis patients ranges between 5 and 20% with great fluctuations depending on the underlying disease, duration of the disease, and the patient's age. Based on slit-lamp examination, uveitis can be classified as granulomatous and non-granulomatous. The effects of uveitic glaucoma on the quality of life and central visual acuity are particularly serious during childhood. Surgical reduction of eye pressure in cases of uveitic secondary glaucoma should only be performed if medical treatment of the underlying disease or ocular inflammation does not lower the eye pressure level and if in the presence of glaucomatous damage to the optic nerve the level of intraocular pressure is so high that a drastic decrease in pressure that cannot be achieved by medication becomes necessary.

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  1. Universitäts-Augenklinik Köln, Köln

    T. S. Dietlein

  2. Zentrum für Augenheilkunde, Universität Köln, Joseph-Stelzmann-Straße 9, 50931 , Köln

    T. S. Dietlein

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Dietlein, T.S. Glaukom und Uveitis. Ophthalmologe 100, 991–1008 (2003). https://doi.org/10.1007/s00347-003-0831-1

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