Intraokulare Manifestationen bei systemischen Tumorerkrankungen

 

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Zusammenfassung

Bei Patienten mit systemischen Tumorerkrankungen besteht eine Vielzahl von möglichen intraokulären Manifestationen. An erster Stelle stehen Metastasen in die Aderhaut, Retina und den Glaskörper von Karzinomen, Melanomen und Lymphomen. Beim von-Hippel-Lindau-Syndrom, der familiären adenomatösen Polyposis coli (FAP), dem Gardner- und Turcot-Syndrom ist die ophthalmologische Primärdiagnostik grundlegend für die Einleitung von Screening-Untersuchungen zum Ausschluss von systemischen Neoplasien (zerebelläres, spinales Hämangioblastom bzw. Nierenzell- und Kolonkarzinom) erforderlich. Weiters gibt es eine Reihe von seltenen paraneoplastischen Syndromen wie die tumor- bzw. melanomassoziierte Retinopathie (CAR, MAR), der paraneoplastischen Optikusneuropathie (PON) sowie die bilaterale diffuse uveale melanozytäre Proliferation (BDUMP), deren Therapien jedoch meistens limitiert und frustran sind.

Abstract

There are multiple possible intraocular manifestations in patients with systemic neoplasms. At first line there are uveal, retinal and vitreous metastases from carcinomas, melanomas and lymphomas. In patients with von Hippel Lindau syndrome or familiar adenomatous polyposis coli (FAP), Gardner or Turcot syndromes, fundus examinations can help in the primary diagnosis and thereby facilitate the early detection of systemic neoplasms such as cerebral and spinal haemangioblastoma, kidney or bowel cancer. Furthermore there are rare ocular paraneoplastic syndromes such as the cancer- or melanoma-associated retinopathies (CAR/MAR), the paraneoplastic optic neuropathy (PON) and the bilateral diffuse melanocytic proliferation (BDUMP) that develop secondary to systemic malignancies and can be the primary manifestation.

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Prof. Dr. Nikolaos E. Bechrakis

Direktor der Univ.-Augenklinik, Medizinische Universität Innsbruck

Anichstr. 35

6020 Innsbruck

Österreich

Phone: ++ 43/5 12/50 42 37 20

Fax: ++ 43/5 12/50 42 37 22

Email: nikolaos.bechrakis@i-med.ac.at