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Klin Monbl Augenheilkd 2015; 232(5): 647-651
DOI: 10.1055/s-0035-1545836
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Klinik der okulären Graft-versus-Host Disease

Clinical Signs of Ocular Graft-versus-Host Disease
T. Dietrich-Ntoukas
1   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
2   Klinik für Augenheilkunde, Charité Universitätsmedizin, Berlin
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Further Information

Publication History

eingereicht 16 February 2015

akzeptiert 23 February 2015

Publication Date:
19 May 2015 (online)

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Zusammenfassung

Hintergrund: Bei der okulären Graft-versus-Host Disease (GvHD) handelt es sich überwiegend um eine inflammatorische Augenoberflächenerkrankung nach allogener hämatopoetischer Stammzelltransplantation (HSCT), deren Inzidenz derzeit zunimmt. Methoden: Überblick über klinische Zeichen der okulären GvHD. Ergebnisse: Die chronische okuläre GvHD als schwere Augenoberflächenerkrankung stellt oft ein langfristiges Problem nach allogener HSCT dar. Sie führt nicht nur zu einer reduzierten Lebensqualität durch ausgeprägte Beschwerden, sondern kann die Sehfähigkeit herabsetzen und zur Erblindung durch korneale Komplikationen führen. Patienten mit chronischer okulärer GvHD sind aufgrund der ausgeprägten Benetzungsstörung und der häufig persistierenden Entzündungsaktivität oft therapierefraktär. Schlussfolgerung: Eine multimodale und interdisziplinäre Therapie – unter Einbeziehung der behandelnden Kollegen der Hämatoonkologie – ist für die Behandlung von GvHD-Patienten essenziell.

Abstract

Background: Ocular graft-versus-host disease (GvHD) is mainly an inflammatory ocular surface disorder after allogeneic hematopoetic stem cell transplantation (HSCT) with increasing incidence. Methods: We present an overview on clinical signs of ocular GvHD. Results: Ocular chronic GvHD representing a severe ocular surface disease is a long-term problem after allogeneic HSCT. It is not only associated with reduced quality of life because of dry eye symptoms but can also impair visual acuity and lead to blindness due to corneal complications. Patients with ocular GvHD are often resistant to therapy because of the severe dry eye disease and persistent inflammatory activity. Conclusion: A multimodal and interdisciplinary therapy – in cooperation with the colleagues from haematology and oncology is important for the treatment of patients with ocular GvHD.

Schlüsselwörter

Kornea - Bindehaut - Lider - GVHD - HSCT - graft-versus-host disease

Key words

conjunctiva - cornea - lids - GVHD - HSCT - graft-versus-host disease
 

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