Zusammenfassung
Dieser Beitrag stellt die epithelialen und subepithelialen Hornhautdystrophien gemäß
IC3D-Klassifikation und deren Abgrenzung gegenüber den Degenerationen dar. Neben der
Einteilung wird auf die Diagnostik und Therapie der Hornhautdystrophien eingegangen;
anschließend werden die einzelnen Krankheitsbilder besprochen.
Abstract
In 2015, the first revision of the international classification of corneal dystrophies
(IC3D) has been published. According to this latest version of the IC3D the dystrophies
of the cornea are divided into
-
epithelial and subepithelial dystrophies,
-
epithelial-stromal TGFBI dystrophies,
-
stromal dystrophies, and
-
Descemet-membrane and endothelial dystrophies.
This article summarizes the epithelial and subepithelial dystrophies of the cornea,
which, according to IC3D are the following:
-
epithelial basement membrane dystrophy (EBMD),
-
epithelial recurrent erosion dystrophy (ERED),
-
subepithelial mucinous corneal dystrophy (SMCD),
-
Meesmann corneal dystrophy (MECD),
-
Lisch epithelial corneal dystrophy (LECD),
-
gelatinous drop-like corneal dystrophy (GDLD).
The main problem concerning almost all dystrophies of the corneal epithelium are epithelial
defects (erosion) associated with pain, epiphora and red eyes. In addition, all dystrophies
of the epithelium tend to relapse.
While therapy is usually initiated with topical therapeutics, in the course of the
disease invasive procedures like phototherapeutic keratectomy (PTK) (possibly with
the administration of mitomycin C) or in severe cases even keratoplasty (preferably
as deep anterior lamellar keratoplasty; DALK) have to be used. Due to the origin of
the disease in the epithelial stem cells at the limbus, the replacement of these cells
can also be discussed.
Schlüsselwörter
IC3D - Hornhautdystrophie - Hornhaut - epitheliale Dystrophie
Key words
IC3D - corneal dystrophy - cornea - epithelial dystrophy
