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01.06.2009 | Das therapeutische Prinzip

Therapeutische Optionen bei Keratoconjunctivitis vernalis

verfasst von: PD Dr. E. M. Messmer

Erschienen in: Die Ophthalmologie | Ausgabe 6/2009

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Zusammenfassung

Die Keratoconjunctivitis vernalis ist eine chronische, saisonal exazerbierende allergische Erkrankung der Lider, der Bindehaut und der Hornhaut. Neben einer IgE-vermittelten Typ-I-Immunreaktion spielen eine T-Zell-vermittelte Immunantwort, eosinophile Granulozyten und unspezifische immunologische Reaktionen eine pathogenetische Rolle. Viele Zytokine, Chemokine, Proteasen und Wachstumsfaktoren sind an der komplexen Entzündungsreaktion beteiligt. Therapeutische Optionen bei Keratoconjunctivitis vernalis umfassen Mastzellstabilisatoren, Antihistaminika, Kortikosteroide und Immunsuppressiva. Neue selektivere Therapeutika wie Antichemokinrezeptorantikörper, Leukotrienrezeptorantagonisten und spezifische Makrobiomoleküle sind in klinischer Erprobung.

Abelson MB, Berdy GJ, Mundorf T et al (2002) Pemirolast potassium 0.1% ophthalmic solution is an effective treatment for allergic conjunctivitis: a pooled analysis of two prospective, randomized, double-masked, placebo-controlled, phase III studies. J Ocul Pharmacol Ther 18:475–488PubMedCrossRef

Akpek EK, Hasiripi H, Christen WG, Kalayci D (2000) A randomized trial of low-dose, topical mitomycin-C in the treatment of severe vernal keratoconjunctivitis. Ophthalmology 107:263–269PubMedCrossRef

Asano-Kato N, Fukagawa K, Okada N et al (2005) TGF-beta1, IL-1beta, and Th2 cytokines stimulate vascular endothelial growth factor production from conjunctival fibroblasts. Exp Eye Res 80:555–560PubMedCrossRef

BenEzra D, Pe’er J, Brodsky M, Cohen E (1986) Cyclosporine eyedrops for the treatment of severe vernal keratoconjunctivitis. Am J Ophthalmol 101:278–282PubMed

Bielory L (2006) Allergic diseases of the eye. Med Clin North Am 90:129–148PubMedCrossRef

Bielory L, Lien KW, Bigelsen S (2005) Efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis. Drugs 65:215–228PubMedCrossRef

Bonini S, Lambiase A, Sgrulletta R, Bonini S (2003) Allergic chronic inflammation of the ocular surface in vernal keratoconjunctivitis. Curr Opin Allergy Clin Immunol 3:381–387PubMedCrossRef

Chan CC, Tuaillon N, Li Q, Shen DF (2000) Therapeutic applications of antiflammin peptides in experimental ocular inflammation. Ann N Y Acad Sci 923:141–146PubMed

Church MK, McGill JI (2002) Human ocular mast cells. Curr Opin Allergy Clin Immunol 2:419–422PubMedCrossRef

10.

Corum I, Yeniad B, Bilgin LK, Ilhan R (2005) Efficiency of olopatadine hydrochloride 0.1% in the treatment of vernal keratoconjunctivitis and goblet cell density. J Ocul Pharmacol Ther 21:400–405PubMedCrossRef

11.

D’Angelo G, Lambiase A, Cortes M et al (2003) Preservative-free diclofenac sodium 0.1% for vernal keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol 241:192–195CrossRef

12.

Fahy GT, Easty DL, Collum LM et al (1992) Randomised double-masked trial of lodoxamide and sodium cromoglycate in allergic eye disease. A multicentre study. Eur J Ophthalmol 2:144–149PubMed

13.

Fukagawa K, Okada N, Fujishima H et al (2002) CC-chemokine receptor 3: a possible target in treatment of allergy-related corneal ulcer. Invest Ophthalmol Vis Sci 43:58–62PubMed

14.

Hingorani M, Calder VL, Buckley RJ, Lightman SL (1998) The role of conjunctival epithelial cells in chronic ocular allergic disease. Exp Eye Res 67:491–500PubMedCrossRef

15.

Hoang-Xuan T, Prisant O, Hannouche D, Robin H (1997) Systemic cyclosporine A in severe atopic keratoconjunctivitis. Ophthalmology 104:1300–1305PubMed

16.

Ilyas H, Slonim CB, Braswell GR et al (2004) Long-term safety of loteprednol etabonate 0.2% in the treatment of seasonal and perennial allergic conjunctivitis. Eye Contact Lens 30:10–13PubMedCrossRef

17.

Irkec M, Bozkurt B (2003) Epithelial cells in ocular allergy. Curr Allergy Asthma Rep 3:352–357PubMedCrossRef

18.

Jun J, Bielory L, Raizman MB (2008) Vernal conjunctivitis. Immunol Allergy Clin North Am 28:59–82, viPubMedCrossRef

19.

Kumar S (2008) Vernal keratoconjunctivitis: a major review. Acta Ophthalmol

20.

Lambiase A, Bonini S, Bonini S et al (1995) Increased plasma levels of nerve growth factor in vernal keratoconjunctivitis and relationship to conjunctival mast cells. Invest Ophthalmol Vis Sci 36:2127–2132PubMed

21.

Lambiase A, Bonini S, Rasi G et al (2003) Montelukast, a leukotriene receptor antagonist, in vernal keratoconjunctivitis associated with asthma. Arch Ophthalmol 121:615–620PubMedCrossRef

22.

Lazarczyk M, Grzela K, Grzela T (2005) Immunostimulatory oligonucleotides in therapy of allergic diseases. Expert Opin Biol Ther 5:525–536PubMedCrossRef

23.

Leonardi A, Borghesan F, Avarello A et al (1997) Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis. Br J Ophthalmol 81:23–26PubMedCrossRef

24.

Leonardi A, Brun P, Abatangelo G et al (2003) Tear levels and activity of matrix metalloproteinase (MMP)-1 and MMP-9 in vernal keratoconjunctivitis. Invest Ophthalmol Vis Sci 44:3052–3058PubMedCrossRef

25.

Leonardi A, Cortivo R, Fregona I et al (2003) Effects of Th2 cytokines on expression of collagen, MMP-1, and TIMP-1 in conjunctival fibroblasts. Invest Ophthalmol Vis Sci 44:183–189PubMedCrossRef

26.

Leonardi A, DeFranchis G, Fregona IA et al (2001) Effects of cyclosporin A on human conjunctival fibroblasts. Arch Ophthalmol 119:1512–1517PubMed

27.

Leonardi A, Motterle L, Bortolotti M (2008) Allergy and the eye. Clin Exp Immunol 153 (Suppl 1):17–21PubMedCrossRef

28.

Lisanework M (2003) Supra-tarsal injection of dexamethasone in the treatment of patients with refractory vernal keratoconjunctivitis. Ethiop Med J 41:19–24PubMed

29.

McGill JI (2004) A review of the use of olopatadine in allergic conjunctivitis. Int Ophthalmol 25:171–179PubMedCrossRef

30.

Messmer EM (2005) [Ocular allergies]. Ophthalmologe 102:527–543PubMedCrossRef

31.

Messmer EM, May CA, Stefani FH et al (2002) Toxic eosinophil granule protein deposition in corneal ulcerations and scars associated with atopic keratoconjunctivitis. Am J Ophthalmol 134:816–821PubMedCrossRef

32.

Montan PG, Ekstrom K, Hedlin G et al (1999) Vernal keratoconjunctivitis in a Stockholm ophthalmic centre--epidemiological, functional, and immunologic investigations. Acta Ophthalmol Scand 77:559–563PubMedCrossRef

33.

Okada N, Fukagawa K, Takano Y et al (2005) The implications of the upregulation of ICAM-1/VCAM-1 expression of corneal fibroblasts on the pathogenesis of allergic keratopathy. Invest Ophthalmol Vis Sci 46:4512–4518PubMedCrossRef

34.

Ozbek Z, Burakgazi AZ, Rapuano CJ (2006) Rapid healing of vernal shield ulcer after surgical debridement: A case report Cornea 25:472–473

35.

Pelegrin L, Gris O, Adan A, Plazas A (2008) Superficial keratectomy and amniotic membrane patch in the treatment of corneal plaque of vernal keratoconjunctivitis. Eur J Ophthalmol 18:131–133PubMed

36.

Pucci N, Novembre E, Cianferoni A et al (2002) Efficacy and safety of cyclosporine eyedrops in vernal keratoconjunctivitis. Ann Allergy Asthma Immunol 89:298–303PubMedCrossRef

37.

Reinhard T, Reis A, Mayweg S et al (2002) [Topical Fk506 in inflammatory corneal and conjunctival diseases. A pilot study.]. Klin Monatsbl Augenheilkd 219:125–131PubMedCrossRef

38.

Rouher N, Pilon F, Dalens H et al (2004) [Implantation of preserved human amniotic membrane for the treatment of shield ulcers and persistent corneal epithelial defects in chronic allergic keratoconjunctivitis]. J Fr Ophtalmol 27:1091–1097PubMedCrossRef

39.

Saini JS, Gupta A, Pandey SK et al (1999) Efficacy of supratarsal dexamethasone versus triamcinolone injection in recalcitrant vernal keratoconjunctivitis. Acta Ophthalmol Scand 77:515–518PubMedCrossRef

40.

Secchi AG, Tognon MS, Leonardi A (1990) Topical use of cyclosporine in the treatment of vernal keratoconjunctivitis. Am J Ophthalmol 110:641–645PubMed

41.

Sharma A, Gupta R, Ram J, Gupta A (1997) Topical ketorolac 0.5% solution for the treatment of vernal keratoconjunctivitis. Indian J Ophthalmol 45:177–180PubMed

42.

Singh S, Pal V, Dhull CS (2001) Supratarsal injection of corticosteroids in the treatment of refractory vernal keratoconjunctivitis. Indian J Ophthalmol 49:241–245PubMed

43.

Solomon A, Puxeddu I, Levi-Schaffer F (2003) Fibrosis in ocular allergic inflammation: recent concepts in the pathogenesis of ocular allergy. Curr Opin Allergy Clin Immunol 3:389–393PubMedCrossRef

44.

Sorkin EM, Ward A (1986) Ocular sodium cromoglycate. An overview of its therapeutic efficacy in allergic eye disease. Drugs 31:131–148PubMedCrossRef

45.

Verin PH, Dicker ID, Mortemousque B (1999) Nedocromil sodium eye drops are more effective than sodium cromoglycate eye drops for the long-term management of vernal keratoconjunctivitis. Clin Exp Allergy 29:529–536PubMedCrossRef

46.

Vichyanond P, Tantimongkolsuk C, Dumrongkigchaiporn P et al (2004) Vernal keratoconjunctivitis: Result of a novel therapy with 0.1% topical ophthalmic FK-506 ointment. J Allergy Clin Immunol 113:355–358PubMedCrossRef

Titel: Therapeutische Optionen bei Keratoconjunctivitis vernalis
verfasst von: PD Dr. E. M. Messmer
Publikationsdatum: 01.06.2009
Verlag: Springer-Verlag
Erschienen in: Die Ophthalmologie / Ausgabe 6/2009
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI: https://doi.org/10.1007/s00347-009-1932-2

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Therapeutische Optionen bei Keratoconjunctivitis vernalis

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