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Erschienen in: Die Ophthalmologie 4/2008

01.04.2008 | CME Weiterbildung • Zertifizierte Fortbildung

Schleimhautpemphigoid mit okulärer Beteiligung

Teil II: Therapie

verfasst von: T. Meyer-ter-Vehn , E. Schmidt, D. Zillikens , Prof. Dr. G. Geerling

Erschienen in: Die Ophthalmologie | Ausgabe 4/2008

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Zusammenfassung

Die Therapie des okulären Schleimhautpemphigoids (SHP) zielt auf eine Reduktion der konjunktivalen Entzündungsreaktion durch systemische Immunsuppression. Zudem erfordert die aus der progredienten Bindehautvernarbung resultierende Oberflächenerkrankung topische konservative und oft auch chirurgische Maßnahmen. Die systemische Therapie umfasst neben Steroiden im akuten Entzündungsintervall verschiedene Immunsuppressiva. In randomisierten Studien konnte Dapson für mildere und Cyclophosphamid für schwere Formen als effektive Therapie etabliert werden. Operativ kommen lidchirurgische Eingriffe für Trichiasis und Entropium, oberflächenrekonstruierende Verfahren, Maßnahmen zur Therapie des trockenen Auges sowie anderer sekundärer Probleme in Frage. Elektive Eingriffe sollten nur durchgeführt werden, wenn die Bindehautentzündung mittels konservativer Therapie kontrolliert ist. Postoperativ besteht die Gefahr einer Exazerbation der Grunderkrankung. Die Betreuung von Patienten mit vernarbendem SHP sollte stets durch mit diesem Krankheitsbild vertraute Ophthalmologen in enger Zusammenarbeit mit Dermatologen und Internisten erfolgen.
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Metadaten
Titel
Schleimhautpemphigoid mit okulärer Beteiligung
Teil II: Therapie
verfasst von
T. Meyer-ter-Vehn
E. Schmidt
D. Zillikens
Prof. Dr. G. Geerling
Publikationsdatum
01.04.2008
Verlag
Springer-Verlag
Erschienen in
Die Ophthalmologie / Ausgabe 4/2008
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-008-1700-8

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