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Augenheilkunde up2date 2019; 9(03): 239-254
DOI: 10.1055/a-0634-7458
Bindehaut, Hornhaut, Lederhaut
Georg Thieme Verlag KG Stuttgart · New York

Sterile Keratitis

Sterile Keratitis
Elisabeth M. Messmer
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Publication History

Publication Date:
16 August 2019 (online)

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Update of:

Sterile KeratitisAugenheilkunde up2date 2013; 3(01): 31-44
DOI: 10.1055/s-0032-1324931

Zusammenfassung

Sterile Keratitiden können als rein okuläres Problem, aber auch im Rahmen einer potenziell letalen Grunderkrankung auftreten. Diagnosestellung und Management dieser Erkrankung sind eine große Herausforderung für den Augenarzt. Neben therapeutischen Grundprinzipien für alle nicht infektiösen Keratitiden und Ulzerationen bestimmt die jeweilige Pathogenese die spezifische, u. U. lebensrettende Behandlung. Daher muss vor jeder Therapie eine akkurate, wegweisende Diagnose stehen.

Abstract

Sterile keratitis shows multiple manifestations. It may occur as an ophthalmological problem but can also be part of a systemic disease, including potentially lethal systemic vasculitis. Diagnosis as well as management of this disease is a challenging task for the ophthalmologist. There are therapeutic principles which apply to all non-infectious cases of keratitis and corneal ulcerations. Specific treatments, however, are determined by the pathogenesis and may differ. Therefore, an accurate diagnosis must guide therapeutic decision making. The correct diagnosis and management of sterile ulcerative keratitis is able to restore the patientʼs vision in most cases. In potentially lethal systemic disease it may even be able to save the patientʼs life.

Kernaussagen

  • Sterile Keratitiden haben eine Vielzahl sehr unterschiedlicher Ursachen. Sie können als rein okuläres Problem, aber auch als Symptom einer Grunderkrankung, z. B. einer potenziell letalen systemischen Vaskulitis auftreten.

  • Nicht nur die Diagnosestellung, auch das Management dieser Erkrankung ist eine große Herausforderung für den Augenarzt.

  • Es gibt zwar therapeutische Grundprinzipien, die für alle nicht infektiösen Keratitiden und Ulzerationen gelten, die spezifische Behandlung wird jedoch durch die jeweilige Pathogenese bestimmt und kann sehr verschieden sein. Daher muss vor jeder therapeutischen Intervention eine akkurate, wegweisende Diagnose stehen.

  • Die korrekte Diagnose und Therapie einer sterilen ulzerativen Keratitis kann zumeist den Visus wiederherstellen und das Auge erhalten, bei potenziell letalen Grunderkrankungen sogar das Leben des Patienten retten.

Schlüsselwörter

periphere ulzerative Keratitis - okuläre Allergie - neurotrophe Keratopathie - interstitielle Keratitis - diffuse lamelläre Keratitis

Key words

peripheral ulcerative keratitis - ocular allergy - neurotrophic keratopathy - interstitial keratitis - diffuse lamellar keratitis
 

  • Weiterführende Literatur

  • 1 Aaltonen V, Alavesa M, Pirilä L. et al. Case report: bilateral Moorenʼs ulcer in association with hepatitis C. BMC Ophthalmology 2017; 17: 239
    CrossrefPubMedGoogle Scholar
  • 2 Aifa A, Gueudry J, Portmann A. et al. Topical treatment with a new matrix therapy agent (RGTA) for the treatment of corneal neurotrophic ulcers. Invest Ophthalmol Vis Sci 2012; 53: 8181-8185
    CrossrefPubMedGoogle Scholar
  • 3 Bains RD, Elbaz U, Zuker RM. et al. Corneal neurotization form the supratrochlear nerve with sural nerve grafts: a minimally invasive approach. Plast Reconstr Surg 2015; 135: 397e-400e
    CrossrefPubMedGoogle Scholar
  • 4 Bonini S, Lambiase A, Rama P. et al. Phase II randomized, double-masked, vehicle-controlled trial of recombinant human nerve growth factor for neurotrophic keratitis. Ophthalmology 2018; 125: 1332-1343
    CrossrefPubMedGoogle Scholar
  • 5 Cao Y, Zhang W, Wu J. et al. Peripheral ulcerative keratitis associated with autoimmune disease. Pathogenesis and treatment. J Ophthalmol 2017; DOI: 10.1155/2017/7298026.
    CrossrefPubMedGoogle Scholar
  • 6 Das S, Mohamed A, Sangwan VS. Clinical course and outcomes in patients with Mooren ulcer who had cataract surgery. J Cataract Refract Surg 2017; 43: 1044-1049
    CrossrefPubMedGoogle Scholar
  • 7 Ding Y, Murri MS, Birdsong OC. et al. Terrien marginal degeneration. Surv Ophthalmol 2019; 64: 162-174
    CrossrefPubMedGoogle Scholar
  • 8 Dong Y, Zhang Y, Xie L. et al. Risk factors, clinical features, and treatment outcomes of recurrent Mooren Ulcers in China. Cornea 2017; 36: 202-209
    CrossrefPubMedGoogle Scholar
  • 9 Dua HS, Said DG, Messmer EM. et al. Neurotrophic keratopathy. Prog Ret Eye Res 2018; 66: 107-131
    CrossrefPubMedGoogle Scholar
  • 10 Durtette C, Hachulla E, Resche-Rigon M. et al. Cogan syndrome: characteristics, outcome and treatment in a French nationwide retrospective study and literature review. Autoimmunity Rev 2017; 16: 1219-1223
    CrossrefPubMedGoogle Scholar
  • 11 Ebrahimiadib N, Modjitahedi BS, Roohipoor R. et al. Successful treatment strategies in granulomatosis with polyangiitis-associated peripheral ulcerative keratitis. Cornea 2016; 35: 1459-1465
    CrossrefPubMedGoogle Scholar
  • 12 Hafezi F, Gatzioufas Z, Seiler TG. et al. Corneal Collagen cross-linking for Terrien marginal degeneration. J Refract Surg 2014; 30: 498-500
    CrossrefPubMedGoogle Scholar
  • 13 Jarade EF, Slim E, Antoune J. et al. Treatment of grade IV diffuse lamellar keratitis with oral doxycycline and topical 10 % sodium citrate. Can J Ophthalmol 2016; 51: 178-184
    CrossrefPubMedGoogle Scholar
  • 14 Johnson JD, Harissi-Dahger M, Pineda R. et al. Diffuse lamellar keratitis: incidence, associations, outcomes, and a new classification. J Cataract Refract Surg 2001; 27: 1560-1566
    CrossrefPubMedGoogle Scholar
  • 15 Linebarger EJ, Hardten DR, Lindstrom RL. Diffuse lamellar keratitis: diagnosis and management. J Cataract Refract Surg 2000; 26: 1072-1077
    CrossrefPubMedGoogle Scholar
  • 16 Lohchab M, Prakash G, Arora T. et al. Surgical management of peripheral corneal thinning disorders. Surv Ophthalmol 2018; 64: 67-78
    PubMedGoogle Scholar
  • 17 Malecha MA, Holland EJ. Peripheral keratitis associated with chronic myelomonocytic leukemia. Cornea 2002; 21: 723-724
    CrossrefPubMedGoogle Scholar
  • 18 Messmer EM. Therapeutische Optionen bei Keratoconjunctivitis vernalis. Ophthalmologe 2009; 106: 557-562
    CrossrefPubMedGoogle Scholar
  • 19 Messmer EM. Klinik und Diagnose der neurotrophen Keratopathie. Ophthalmologe 2019; 116: 120-126 doi:10.1007/s00347-018-0822-x
    CrossrefPubMedGoogle Scholar
  • 20 Messmer EM, Foster CS. Vasculitic peripheral ulcerative keratitis. Surv Ophthalmol 1999; 43: 379-396
    CrossrefPubMedGoogle Scholar
  • 21 Miyazaki D, Fukushima A, Ohashi Y. et al. Steroid-sparing effect of 0,1 % Tacrolimus eye drop for treatment of shield ulcer and corneal epitheliopathy in refractory allergic ocular disease. Ophthalmology 2017; 124: 287-294
    CrossrefPubMedGoogle Scholar
  • 22 Özcura F. Successful treatment of staphylococcus-associated marginal keratitis with topical cyclosporine. Graefes Arch Clin Exp Ophthalmol 2010; 248: 1049-1050
    CrossrefPubMedGoogle Scholar
  • 23 Reddy JC, Basu S, Saboo US. et al. Management, clinical outcomes, and complications of shild ulcers in vernal keratoconjunctivitis. Am J Ophthalmol 2013; 155: 550-559
    CrossrefPubMedGoogle Scholar
  • 24 Reinstein DZ, Stuart AJ, Vida RS. et al. Incidence and outcomes of sterile multifocal inflammatory keratitis and diffuse lamellar keratitis after SMILE. J Refract Surg 2018; 34: 751-759
    CrossrefPubMedGoogle Scholar
  • 25 Schwartz GS, Harrison AR, Holland EJ. Etiology of immune stromal (interstitial) keratitis. Cornea 1998; 17: 278-281
    CrossrefPubMedGoogle Scholar
  • 26 Watanabe R, Ishii T, Yoshida M. et al. Ulcerative keratitis in patients with rheumatoid arthritis in the modern biologic era: a series of eight cases and literature review. Int J Rheum Dis 2017; 20: 225-230
    CrossrefPubMedGoogle Scholar
  • 27 Yangzes S, Dogra M, Ram J. Interstitial keratitis with corneal perforation as the presenting sign of systemic tuberculosis. Ocul Immunol Inflamm 2019; DOI: 10.1080/09273948.2019.1568504.
    CrossrefPubMedGoogle Scholar
  • 28 Yazdanyar A, Rizzuti A, Mechel E. et al. Gout Keratitis: a case of peripheral ulcerative keratitis secondary to gout with a review of the literature. Cornea 2018; 37: 379-381
    CrossrefPubMedGoogle Scholar
  • 29 Zegans ME, Srinivasan M. Moorenʼs ulcer. Int Ophthalmol Clin 1998; 38: 81-88
    CrossrefPubMedGoogle Scholar