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304 Kapitel 7  •  Infektiös

1

Prognose

Angaben der WHO zufolge ist eine antituberkulöse The-

2

rapie in ca. 4 von 5 Fällen erfolgreich. Bei Patienten, die an

einer MDR (multidrugresistant-)Tuberkulose leiden, liegt

 

die Erfolgsrate bei unter 70 %.

3

Die Prognose der okulären Tuberkulose ist abhängig

von:

 

4

Alter

Immunabwehr

5

-TherapieSensibilität des Erregers auf die tuberkulostatische

 

Compliance (Anfangs Einnahme von bis zu 12 Tab-

6

-letten täglich)

Stadium der Erkrankung (bereits eingetretene irre-

7

-versible Schäden?)

Der Therapieerfolg am Auge kann nur klinisch bewertet

 

8

werden, da indirekte (serologische) Tests, wie der Quan-

tiferon-Test erst Jahre nach erfolgreicher Therapie negativ

 

9

werden. Alle diese Punkte müssen mit den Patienten vor

Therapiebeginn besprochen werden, und das Therapieziel

10

muss gemeinsam festgelegt werden. Je nach Alter des Pati-

enten, Begleiterkrankungen und Schweregrad der Augen-

 

beteiligung kann auch eine abwartende Haltung vereinbart

11

werden. .Abbildung7.7 zeigt einen erfolgreich therapier-

ten Patienten.

12

Selbsthilfegruppen und hilfreiche Websites

 

http://www.uveitis-selbsthilfe.de, http://www.duag.org,

13

http://www.tbc-sh.de/ http://uveitis.jimdo.com

 

14

Literatur

15

Literatur zu Abschn. 7.1.1

16

Abghari SZ, Stulting RD, Zhu Z, Schinazi RF, Kaufmann HE (1994) Effect

of genetically determined host factors on the efficacy of vidarabine,

 

 

acyclovir and 5-trifluorothymidine in herpes simplex virus type 1

17

infection. Ophthalmic Res 1994; 26:95–104

Akiba M, Yoshida I, Suzutani T, Ogasawara M, Azuma M (1996) Relati-

 

 

onship of the strain and the intraocular amount of herpes simplex

18

virus types 1 and 2 in the induction of anterior-chamber-associated

immune deviation. Ophthalmic Res 1996; 28:289–95

 

Anwar Z, Galor A, Albini TA, Miller D, Perez V, Davis JL (2013) The Diag-

19

nostic Utility of Anterior Chamber Paracentesis With Polymerase

Chain Reaction in Anterior Uveitis. Am J Ophthalmol 155(5):781–6

 

Bloch-Michel E, Dussaix E, Cerqueti P (1987) Patarin Possible role of cy-

20

tomegalovirus infection in the etiology of the Posner-Schlossman

syndrome. Int Ophthalmol 11:95–96

 

Chee SP, Bacsal K, Jap A, Se-Thoe SY, Cheng CL (2008) Tan Clinical fea-

21

tures of cytomegalovirus anterior uveitis in immunocompetent

patients. Am J Ophthalmol 2008; 145:834–840

 

Chee SP, Jap A (2008) Presumed fuchs heterochromic iridocyclitis and

22

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Chee SP, Bacsal K, Jap A et al (2008) Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients. Am J Ophthalmol 2008; 145:834–840

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Kido S, Sugita S, Horie S, Miyanaga M, Miyata K, Shimizu N, Morio T, Mochizuki M (2008) Association of varicella zoster virus load in the aqueous humor with clinical manifestations of anterior uveitis in herpes zoster ophthalmicus and zoster sine herpete. Br J Ophthalmol 92:505–8

Koizumi N, Suzuki T, Uno T et al (2008) Cytomegalovirus as an etiologic factor in corneal endotheliitis. Ophthalmology 2008; 115:292–297 Liekfeld A, Schweig F, Jaeckel C, Wernecke KD, Hartmann C, Pleyer U (2000) Intraocular antibody production in intraocular inflamma-

tion. Graefes Arch Clin Exp Ophthalmol 238:222–7

Liesegang TJ (2001) Herpes simplex virus epidemiology and ocular importance. Cornea 2001; 20:1–13

Mietz H, Aisenbrey S, Bartz-Schmidt KU, Bamborschke S, Krieglstein GK (2000) Ganciclovir for the treatment of anterior uveitis. Graefes Arch Clin Exp Ophthalmol 238:905–909

Miserocchi E, Waheed NK, Dios E, Christen W, Merayo J, Roque M, Foster CS (2002) Visual outcome in herpes simplex virus and varicella zoster virus uveitis: a clinical evaluation and comparison. Ophthalmology 109:1532–7

Pavan-Langston D, Welch CL, Zegans ME (2012) Ganciclovir gel for cytomegalovirus keratouveitis. Ophthalmology 119(11):2411

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Sungur GK, Hazirolan D, Yalvac IS et al (2010) Incidence and prognosis of ocular hypertension secondary to viral uveitis. Int Ophthalmol 2010; 30:191–194

Tugal-Tutkun I, Otu¨ k-Yasar B, Altinkurt E (2010) Clinical features and prognosis of herpetic anterior uveitis: a retrospective study of 111 cases. Int Ophthalmol 30:559–565

Van Boxtel LA, van der Lelij A, van der Meer J, Los LI (2007) Cytomegalovirus as acause of anterior uveitis in immunocompetent patients. Ophthalmology 114:1358–1362

Wensing B, Relvas LM, Caspers LE, Valentincic NV, Stunf S, de Groot-Mij- nes JD, Rothova A (2011) Comparison of rubella virusand herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis. Ophthalmology 118(10):1905–10

Wertheim MS, Mathers WD, Planck SJ et al (2012) In vivo confocal microscopy of keratic precipitates. Arch Ophthalmol 2004; 122: 1773–81. Clin Ophthalmol. 2012;6:595–600

Wong VW, Chan CK, Leung DY, Lai TY (2012) Long-term results of oral valganciclovir for treatment of anterior segment inflammation secondary to cytomegalovirus infection. Clin Ophthalmol 2012; 6:595–600

Literatur zu Abschn. 7.1.2

Aggarwal RK, Luck J, Coster DJ (1994) Horner’syndrom and Fuchs’heterochromic uveitis. Br J Ophthalmol 78:949

Birnbaum AD, Tessler HH, Schultz KL, Farber MD, Lin P, Oh F, Goldstein DA (2007) Epidemiologic relationship between Fuchs’ heterochromic iridocyclitis and the United States rubella vaccinatin program. Am J Ophthalmol 144:424–428

Fuchs E (1906) Über Komplikationen der Heterochromie. Z Augenheilkd 15:191–212

deGroot-Mijnes JD, de Visser L, Rothova A, Schuller M, vanLoon AM, Weersink AJ (2006) Rubella virus association with Fuchs’ heterochromic iridocyclitis. Am J Ophthalmol 141:212–214

Ganesh SK, Sharma S, Narayana KM, Biswas J (2004) Fuchs’ heterochromic iridocyclitis following bilateral ocular toxoplamosis. Ocul Immunol Inflamm 12:75–77

Jones NP (1993) Fuchs’heterochromic uveitis: an update. Surv Ophthalmol 37:253–272

La Hey E, Baarsmam GS, de Vris J, Kijlstra (1991) Clincal analysis of Fuchs’ heterochromic cyclitis. Documenta Ophthalmologica 78:225–235 Labalett P, Caillau D, Grutzmacher C, Dessaint JP, Labalett M (2002) Highly focused clonal composition of CD8(Arial/F02B)CD28(neg)

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Ruokonen PC, Metzner S, Ücer A, Torun N, Hofmann J, Pleyer U (2010) Intraocular antibody synthesis against rubella virus and other microorganisms in Fuchs’heterocromic cyclitis. Graefes Arch Clin Exp Ophthalmol 248:565–571

Schwab IR (1991) The epidemiologic association of Fuchs’heterochromic iridocyclitis and ocular toxoplasmois. Am J Ophthalmol 15:356–362 van der Lelij A, Rothova A (1997) Diagnostic anterior chamber paracentesis in uveitis: a safe procedure? Br J Ophthalmol 81:976–979

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Ang M et al (2012) Duration of anti-tubercular therapy in uveitis associated with latent tuberculosis: a case-control study. Br J Ophthalmol 96(3):332–6

Bansal R et al (2008) Role of anti-tubercular therapy in uveitis with latent/manifest tuberculosis. Am J Ophthalmol 146:772–779

Bouza E, Merino P, Munoz P et al (1997) Ocular tuberculosis. A prospective study in a general hospital. Medicine 76:53–61

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95(9):1290–4

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Gineys R et al (2011) QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol 152(3):433–440

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306 Kapitel 7  •  Infektiös

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