Klin Monbl Augenheilkd 2014; 231(11): 1093-1096
DOI: 10.1055/s-0034-1382976
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Konservative Therapie des trockenen Auges

Conservative Treatment of Dry Eye
J. Hefner
Augenzentrum, Pallas Kliniken, Olten, Schweiz
,
H. Reinshagen
Augenzentrum, Pallas Kliniken, Olten, Schweiz
› Author Affiliations
Further Information

Publication History

eingereicht 26 May 2014

akzeptiert 26 June 2014

Publication Date:
02 October 2014 (online)

Zusammenfassung

Der Einsatz topischer antientzündlicher Substanzen hat einen wichtigen Stellenwert in der Behandlung des trockenen Auges eingenommen. Neben der Basistherapie mit Tränenersatzmitteln, der Anwendung mukolytischer Augentropfen oder Eigenserumaugentropfen kommen daher bei ausgeprägten Formen des trockenen Auges immer häufiger topische Kortikosteroide oder Cyclosporin-A-Augentropfen zur Anwendung. Eine besondere Bedeutung kommt zudem der konsequenten Behandlung einer häufig zugrundeliegenden Meibom-Drüsen-Dysfunktion zu. Eine erfolgreiche Behandlung dieses häufigen Krankheitsbilds erfordert sowohl das Verständnis für die Chronizität der Erkrankung als auch eine langfristige Mitarbeit vonseiten des Patienten.

Abstract

The use of topic anti-inflammatory drugs has become very important in the treatment of dry eye disease. Besides the basic therapy including tear replacement, use of serum eye drops and mucolytic eye drops, the topical application of corticosteroids and cyclosporin A is more commonly used in moderate to severe forms of dry eye disease. The consistent treatment of Meibomian gland dysfunction as a frequent reason for evaporative dry eye is also of particular importance. Understanding the chronicity of the disease and long-term compliance are the essential for successful therapy of this widespread disease.

 
  • Literatur

  • 1 Schirra F, Ruprecht KW. Das trockene Auge. Ein Update über Epidemiologie, Diagnose, Therapie und neue Konzepte. Ophthalmologe 2004; 101: 10-18
  • 2 Jacobi C, Bellios N, Jacobi A et al. Erhebungsbogen zur Anamnese und Diagnostik des trockenen Auges. Klin Monatsbl Augenheilkd 2011; 228: 226-233
  • 3 [no authors listed] The definition and classification of dry eye disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Workshop (2007). Ocul Surf 2007; 5: 75-92
  • 4 Pflugfelder SC. Antiinflammatory therapy for dry eye. Am J Ophthalmol 2004; 137: 337-342
  • 5 Jacobi C, Dietrich T, Cursiefen C et al. Das trockene Auge. Aktuelle Konzepte zur Klassifizierung, Diagnostik und Pathogenese. Ophthalmologe 2006; 103: 9-17
  • 6 Nichols KK, Foulks GN, Bron AJ et al. Report of the International Workshop on Meibomian Gland Dysfunction. Invest Ophthalmol Vis Sci 2011; 52: 1922-1929
  • 7 [no authors listed] The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007; 5: 93-107
  • 8 [no authors listed] Management and therapy of dry eye disease: Report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007; 5: 163-178
  • 9 Behrens A, Doyle JJ, Stern L et al. Dysfunctional tear syndrome: A Delphi approach to treatment recommendations. Cornea 2006; 25: 900-907
  • 10 Cursiefen C, Jacobi C, Dietrich T et al. Aktuelle Therapie des trockenen Auges. Ophthalmologe 2006; 103: 18-24
  • 11 Brignole-Baudouin F, Baudouin C, Aragona P et al. A multicenter, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients. Acta Ophthalmol 2011; 89: e591-e597
  • 12 Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother 2002; 56: 365-379
  • 13 Olenik A, Jimenez-Alfaro I, Alejandre-Alba N et al. A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction. Clin Interv Aging 2013; 8: 1133-1138
  • 14 Messmer EM. Konservierungsmittel in der Ophthalmologie. Ophthalmologe 2012; 109: 1064-1070
  • 15 Erb C, Schlote T. Medikamentöse Augentherapie. 5.. Aufl. Stuttgart: Thieme; 2010
  • 16 Christensen MT, Cohen S, Rinehart J et al. Clinical evaluation of an HP-guar gellable lubricant eye drop for the relief of dryness of the eye. Curr Eye Res 2004; 28: 55-62
  • 17 Yoo SE, Lee DC, Chang MH. The effect of low-dose doxycycline therapy in chronic meibomian gland dysfunction. Korean J Ophthalmol 2005; 19: 258-263
  • 18 Yeh S, Song XJ, Farley W et al. Apoptosis of ocular surface cells in experimentally induced dry eye. Invest Ophthalmol Vis Sci 2003; 44: 124-129
  • 19 Kunert KS, Tisdale AS, Gipson IK. Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine. Arch Ophthalmol 2002; 120: 330-337
  • 20 Avunduk AM, Avunduk MC, Varnell ED et al. The comparison of efficacies of topical corticosteroids and nonsteroidal anti-inflammatory drops on dry eye patients: A clinical and immunocytochemical study. Am J Ophthalmol 2003; 136: 593-602
  • 21 Sall K, Stevensons OD, Mundorf TK et al. Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. Ophthalmology 2000; 107: 631-639
  • 22 Baxter SA, Laibson PR. Punctal Plugs in the management of dry eyes. Ocul Surf 2004; 2: 255-265
  • 23 Paulsen F. The human lacrimal glands. Adv Anat Embryol Cell Biol 2003; 170: 1-106
  • 24 Tauber J, Davitt WF, Bokosky JE et al. Double-masked placebo-controlled safety and efficacy trial of diquafosol tetrasodium (INS365) ophthalmic solution for the treatment of dry eye. Cornea 2004; 23: 784-792
  • 25 Yerxa BR, Douglass JG, Elena PP et al. Potency and duration of action of synthetic P2Y2 receptor agonists on Schirmer scores in rabbits. Adv Exp Med Biol 2002; 506: 261-265
  • 26 Jackson 2nd RS, Van Dyken SJ, McCartney MD et al. The eicosanoid, 15-(S)-HETE, stimulates mucin-like glycoprotein by the corneal epithelium. Cornea 2001; 20: 516-521
  • 27 Aragona P, Di Pietro R, Spinella R et al. Conjunctival epithelium improvement after systemic pilocarpine in patients with Sjogrenʼs syndrome. Br J Ophthalmol 2006; 90: 166-170
  • 28 Petrone D, Condemi JJ, Fife R et al. Double-blind randomized placebo-controlled study of cevimeline in Sjogrenʼs syndrome patients with xerostomia and keratoconjunctivitis sicca. Arthritis Rheum 2002; 46: 748-754
  • 29 Kojima T, Ishida R, Dogru M et al. The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case-control study. Am J Ophthalmol 2005; 139: 242-246
  • 30 Pullum KW, Whiting MA, Buckley MJ. Scleral contact lenses: the expanding role. Cornea 2005; 24: 269-277