Klin Monbl Augenheilkd 2014; 231(5): 518-521
DOI: 10.1055/s-0034-1368334
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Gigantopapilläre Konjunktivitis

Giant Papillary Conjunctivitis
G. Bischoff
Praxis & Klinik, Medical Eye-Care Center, Hamburg
› Author Affiliations
Further Information

Publication History

eingereicht 14 January 2014

akzeptiert 10 March 2014

Publication Date:
05 May 2014 (online)

Zusammenfassung

Die GPC ist eine Erkrankung der Konjunktiva, die dem immunologisch-allergischen Formenkreis zugerechnet wird, aber sich nicht in allen Bereichen einfach einordnen lässt. Pathogenetisch werden bei disponierten Trägern Linsenablagerungen angeschuldigt. Sie induzieren eine spezifische Immunantwort durch ihre biochemische Zusammensetzung. In Kombination mit einer aufgerauten Oberfläche der Kornea und Konjunktiva kommt es additiv zu mechanisch induzierten großen Papillen, vorzugsweise am oberen Tarsus und der Konjunktiva der Lider. Dieses wird sogar unabhängig von den Kontaktlinsen beobachtet, nach filtrierender Glaukomoperation und anderen Veränderungen des äußeren Auges, welche die glatte Oberfläche des äußeren Auges beeinträchtigen. Waren es früher gehäuft die Proteinablagerungen auf den Hydrogellinsen, so treten heute Papillenbildungen auch auf durch gemischte Protein- und Lipidablagerungen der Silikon-Hydrogellinsen. Die mangelnde Compliance der Linsenträger in Bezug auf die tägliche Tragezeit ist ein weiterer Faktor, der das Auftreten der GPC fördert.

Abstract

Giant papillary conjunctivitis is an inflammation of the conjunctiva, which is associated with immunological-allergic disorders, but is difficult to integrate as a defined type of illness. The deposits of contact lenses are responsible in predisposed wearers. They induce a special immune answer to their biochemical ingredients. In addition, roughness of the superficial corneal layers and the conjunctiva, even without any contact lenses after filtrating glaucoma surgery, leads to mechanically induced papillary formations. In former days these symptoms of building giant papillae were seen mostly in wearers of soft hydrogel contact lenses. Nowadays manufacturers have developed contact lens systems with a variety of material components, with an increase of protein and lipid deposits. In combination with the observed non-compliance of wearers regarding lens exchange and contact lens hygiene, GPC is an issue which should be taken into consideration again.

 
  • Literatur

  • 1 Skrypuch OW, Willis NR. Giant papillary conjunctivitis from an exposed prolene suture. Can J Ophthalmol 1986; 21: 189-192
  • 2 Katelaris CH. Giant papillary conjunctivitis–a review. Acta Ophthalmol Scand Suppl 1999; 228: 17-20
  • 3 Douglas JP, Lowder CY, Lazorik R et al. Giant papillary conjunctivitis associated with rigid gas permeable contact lenses. CLAO J 1988; 14: 143-147
  • 4 Donshik PC, Ehlers WH, Ballow M. Giant papillary conjunctivitis. Immunol Allergy Clin North Am 2008; 28: 83-103 vi
  • 5 Forister JF, Forister EF, Yeung KK et al. Prevalence of contact lens-related complications: UCLA contact lens study. Eye Contact Lens 2009; 35: 176-180
  • 6 Nagachandrika T, Kumar U, Dumpati S et al. Prevalence of contact lens related complications in a tertiary eye centre in India. Contact Lens Anterior Eye 2011; 34: 266-268
  • 7 Teo L, Lim L, Tan DT et al. A survey of contact lens complications in Singapore. Eye Contact Lens 2011; 37: 16-19
  • 8 Suvajac G. [Soft-contact-lenses-induced complications]. Vojnosanitetski pregled (Military-medical and pharmaceutical review) 2008; 65: 15-20
  • 9 Donshik PC. Contact lens chemistry and giant papillary conjunctivitis. Eye Contact Lens 2003; 29 (Suppl. 01) S37-S39
  • 10 Donshik PC, Porazinski AD. Giant papillary conjunctivitis in frequent-replacement contact lens wearers: a retrospective study. TAOS 1999; 97: 205-216 (discussion 216–220)
  • 11 Porazinski AD, Donshik PC. Giant papillary conjunctivitis in frequent replacement contact lens wearers: a retrospective study. CLAO J 1999; 25: 142-147
  • 12 Kanemoto M, Toshida H, Takahiro I et al. Prosthetic soft contact lenses in Japan. Eye Contact Lens 2007; 33: 300-303
  • 13 Cheung SW, Cho P, Chan B et al. A comparative study of biweekly disposable contact lenses: silicone hydrogel versus hydrogel. Clin Exp Optom 2007; 90: 124-131
  • 14 Covey M, Sweeney DF, Terry R et al. Hypoxic effects on the anterior eye of high-Dk soft contact lens wearers are negligible. OVS 2001; 78: 95-99
  • 15 Dart JK, Radford CF, Minassian D et al. Risk factors for microbial keratitis with contemporary contact lenses: a case-control study. Ophthalmology 2008; 115: 1647-1654 1654.e1–1654.e3
  • 16 Zhao Z, Fu H, Skotnitsky CC et al. IgE antibody on worn highly oxygen-permeable silicone hydrogel contact lenses from patients with contact lens-induced papillary conjunctivitis (CLPC). Eye Contact Lens 2008; 34: 117-121
  • 17 Richard NR, Anderson JA, Tasevska ZG et al. Evaluation of tear protein deposits on contact lenses from patients with and without giant papillary conjunctivitis. CLAO J 1992; 18: 143-147
  • 18 Zhong X, Liu H, Pu A et al. M cells are involved in pathogenesis of human contact lens-associated giant papillary conjunctivitis. Arch Immunol Ther Exper 2007; 55: 173-177
  • 19 Elhers WH, Donshik PC. Giant papillary conjunctivitis. Curr Op Aller Clin Immunol 2008; 8: 445-449
  • 20 Sarac O, Erdener U, Irkec M et al. Tear eotaxin levels in giant papillary conjunctivitis associated with ocular prosthesis. Ocular Immunol Inflamm 2003; 11: 223-230
  • 21 Sengor T, Irkec M, Gulen Y et al. Tear LTC4 levels in patients with subclinical contact lens related giant papillary conjunctivitis. CLAO J 1995; 21: 159-162
  • 22 Irkec MT, Orhan M, Erdener U. Role of tear inflammatory mediators in contact lens-associated giant papillary conjunctivitis in soft contact lens wearers. Ocular Immunol Inflamm 1999; 7: 35-38
  • 23 Irkec M, Orhan M. Effect of extended wear disposable contact lenses on tear LTC4 in giant papillary conjunctivitis. Ocular Immunol Inflamm 1995; 3: 107-112
  • 24 Molinari JF. The clinical management of giant papillary conjunctivitis. Am J Optom Physiol Opt 1981; 58: 886-891
  • 25 Kruger CJ, Ehlers WH, Luistro AE et al. Treatment of giant papillary conjunctivitis with cromolyn sodium. CLAO J 1992; 18: 46-48
  • 26 Bilkhu P, Wolffsohn JS, Taylor D et al. The management of ocular allergy in community pharmacies in the United Kingdom. Int J Clin Pharm 2013; 35: 190-194
  • 27 Diao H, She Z, Cao D et al. Comparison of tacrolimus, fluorometholone, and saline in mild-to-moderate contact lens-induced papillary conjunctivitis. Adv Ther 2012; 29: 645-653
  • 28 Asbell P, Howes J. A double-masked, placebo-controlled evaluation of the efficacy and safety of loteprednol etabonate in the treatment of giant papillary conjunctivitis. CLAO J 1997; 23: 31-36
  • 29 Lustine T, Bouchard CS, Cavanagh HD. Continued contact lens wear in patients with giant papillary conjunctivitis. CLAO J 1991; 17: 104-107
  • 30 Khurana S, Sharma N, Agarwal T et al. Comparison of olopatadine and fluorometholone in contact lens-induced papillary conjunctivitis. Eye Contact Lens 2010; 36: 210-214
  • 31 [no authors listed] A Handbook of Contact Lens Management. Wokingham: Johnson & Johnson Medical Ltd.; 2011