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26.11.2018 | Erkrankungen der Hornhaut | Leitthema

Pathogenese und Epidemiologie der neurotrophen Keratopathie

verfasst von: Dr. rer. nat. S. Mertsch, J. Alder, H. S. Dua, G. Geerling

Erschienen in: Die Ophthalmologie | Ausgabe 2/2019

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Zusammenfassung

Die neurotrophe Keratopathie (NK) ist eine degenerative Hornhauterkrankung, die auf einer Beeinträchtigung der kornealen Innervation beruht. Die Schädigung der sensiblen Innervation, die durch den 1. Ast des N. trigeminus (N. ophthalmicus) erfolgt, kann über die gesamte Länge des Nervenverlaufs erfolgen, ausgehend vom Kern im Hirnstamm z. B. durch einen Hirntumor, bis hin zu den terminalen Nervenfasern in der Kornea, z. B. verursacht durch refraktive Hornhautchirurgie (z. B. Laser-in-situ-Keratomileusis [LASIK]). Bedingt durch den Verlust der sensiblen Innervation kommt es zu einer verminderten Tränensekretion und einer Reduktion in der Ausschüttung trophischer Faktoren. Dieses wiederum inhibiert das Regenerationspotenzial des kornealen Epithels. Die Reduktion bzw. der Verlust der Tränensekretion gepaart mit dem verschlechterten Regenerationspotenzial der Epithelzellen kann in schwersten Fällen der Erkrankung zu persistierenden Epitheldefekten, Ulzera bis hin zur Perforation der Hornhaut führen. Die NK weist eine Prävalenz von 5 oder weniger Betroffenen pro 10.000 auf und wird als seltene/Orphan-Erkrankung (ORPHA137596) eingestuft. Ein grundlegendes Verständnis der Pathogenese und Epidemiologie der NK unterstützt eine frühzeitige Diagnose und damit die Einleitung einer spezifischen Therapie.

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Titel: Pathogenese und Epidemiologie der neurotrophen Keratopathie
verfasst von: Dr. rer. nat. S. Mertsch
J. Alder
H. S. Dua
G. Geerling
Publikationsdatum: 26.11.2018
Verlag: Springer Medizin
Schlagwort: Erkrankungen der Hornhaut
Erschienen in: Die Ophthalmologie / Ausgabe 2/2019
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI: https://doi.org/10.1007/s00347-018-0823-9

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