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Therapie der intermediären Uveitis

Therapy of intermediate uveitis

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Zusammenfassung

Bei der intermediären Uveitis handelt es sich um eine Uveitisform, bei welcher der Schwerpunkt der Entzündung im Glaskörper liegt. Die intermediäre Uveitis wird primär medikamentös behandelt. Die systemischen Kortikosteroide stellen den Goldstandard in der Therapie der intermediären Uveitis dar. Wenn Rezidive der Uveitis oder Nebenwirkungen unter der systemischen Steroidtherapie auftreten, ist eine immunsuppressive Therapie indiziert. Bislang ist Ciclosporin A das einzige in Deutschland zugelassene Immunsuppressivum bei Uveitis. Klinische Studien zeigen jedoch auch für andere Immunsuppressiva eine gute Wirksamkeit und Verträglichkeit bei intermediärer Uveitis. Bei schweren therapieresistenten Fällen können Biologika eingesetzt werden. Bei Patienten mit einseitiger Uveitis oder wenn eine systemische Therapie wegen Nebenwirkungen kontraindiziert ist, kann eine intravitreale Steroidtherapie angewendet werden. Eine Vitrektomie bleibt bestimmten Fällen vorbehalten.

Abstract

Intermediate uveitis is a form of intraocular inflammation in which the vitreous body is the major site of inflammation. Intermediate uveitis is primarily treated medicinally and systemic corticosteroids are the mainstay of therapy. When recurrence of uveitis or side effects occur during corticosteroid therapy an immunosuppressive treatment is required. Cyclosporine A is the only immunosuppressive agent that is approved for therapy of uveitis in Germany; however, other immunosuppressive drugs have also been shown to be effective and well-tolerated in patients with intermediate uveitis. In severe therapy-refractory cases when conventional immunosuppressive therapy has failed, biologics can be used. In patients with unilateral uveitis or when the systemic therapy is contraindicated because of side effects, an intravitreal steroid treatment can be carried out. In certain cases a vitrectomy may be used.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. D. Doycheva, C. Deuter und M. Zierhut geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Universitäts-Augenklinik Tübingen, Schleichstr. 12–16, 72076, Tübingen, Deutschland

    D. Doycheva, C. Deuter & M. Zierhut

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  1. D. Doycheva
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  2. C. Deuter
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  3. M. Zierhut
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Correspondence to D. Doycheva.

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Doycheva, D., Deuter, C. & Zierhut, M. Therapie der intermediären Uveitis. Ophthalmologe 111, 1219–1234 (2014). https://doi.org/10.1007/s00347-014-3201-2

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