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Ophthalmologische Komplikationen beim Sjögren-Syndrom

Diagnostik und Therapie

Ophthalmological complications in Sjögren’s syndrome

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Zeitschrift für Rheumatologie Aims and scope Submit manuscript

Der vorliegende Artikel enthält aktualisierte Bestandteile der Arbeiten Cursiefen C, Jacobi C, Dietrich T, Kruse FE (2006) Current treatment for dry eye syndrome. Ophthalmologe 103:18–24 und Jacobi C, Dietrich T, Cursiefen C, Kruse FE (2006) The dry eye. Current concepts on classification, diagnostics, and pathogenesis. Ophthalmologe 103:9–17

Zusammenfassung

Hintergrund

Okuläre Komplikationen sind eine typische Folge des primären und sekundären Sjögren-Syndroms. Da diese bei unzureichenden Therapiemaßnahmen bis zur Erblindung führen können, sollen diagnostische Verfahren und Therapiemöglichkeiten dargestellt werden.

Methoden

Literaturübersicht aus PubMed und eigene klinische und experimentelle Daten.

Ergebnisse

Beim primären und sekundären Sjögren-Syndrom kommt es zu zahlreichen Komplikationen am Auge. Im Vordergrund stehen Störungen des präkornealen Tränenfilms.

Schlussfolgerungen

Eine frühzeitige und enge Kooperation zwischen Rheumatologen und Augenarzt kann das Entstehen von visusbedrohenden Langzeitkomplikationen beim Sjögren-Syndrom vermeiden.

Abstract

Background

Ocular complications are typical sequels of primary and secondary Sjögren’s syndrome. Since these can lead to blindness in the case of insufficient therapeutic steps, diagnostic tools and therapeutic options in Sjögren-syndrome associated ocular diseases are outlined.

Methods

Literature review from PubMed and own clinical and experimental results.

Results

Numerous ocular complications can occur both in primary and secondary Sjögren’s syndrome. The main problems involve tear film disturbances leading to severe forms of dry eye.

Conclusion

Early and close cooperation between rheumatologist and ophthalmologist can avoid long-term complications in patients with Sjögren’s disease and ocular complications.

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Literatur

  1. Avunduk AM, Avunduk MC, Varnell ED, Kaufmann HE (2003) The comparison of efficacies of topical corticosteroids and nonsteroidal anti-inflammatory drops on dry eye patients: a clinical and immunocytochemical study. Am J Ophthalmol 136:593–602

    Article  CAS  PubMed  Google Scholar 

  2. Barabino S, Rolando M, Camicione P et al (2003) Systemic linolenic and gamma-linolenic acid therapy in dry eye syndrome with an inflammatory component. Cornea 22:97–101

    Article  PubMed  Google Scholar 

  3. Baudouin C, Brignole F, Pisella PJ et al (2002) Flow cytometric analysis of the inflammatory marker HLA-DR in dry eye syndrome: results from 12 months of randomized treatment with topical cyclosporin A. Adv Exp Med Biol 506:761–769

    CAS  PubMed  Google Scholar 

  4. Baudouin C, Hamard P, Liang H et al (2004) Conjunctival epithelial cell expression of interleukins and inflammatory markers in glaucoma patients treated over the long term. Ophthalmology 111:2186–2192

    Article  PubMed  Google Scholar 

  5. Brewitt H, Zierhut M (2001) Trockenes Auge. Anatomie Physiologie Pathophysiologie Diagnostik Therapie. Dr. Reinhard Kaden, Heidelberg

  6. Brignole F, Pisella PJ, De Saint Jean M et al (2001) Flow cytometric analysis of inflammatory markers in KCS: 6-month treatment with topical cyclosporin A. Invest Ophthalmol Vis Sci 42:90–95

    CAS  PubMed  Google Scholar 

  7. Cursiefen C, Seitz B, Kruse FE (2005) Neurotrophe Keratopathie, Pathogenese, Klinik und Diagnostik. Ophthalmologe 102:7–14

    Article  CAS  PubMed  Google Scholar 

  8. Cursiefen C, Rummelt C, Beckmann MW, Kruse FE (2007) Amniotic membrane-covered bio-onlays for treatment of ocular surface disease. Br J Ophthalmol 91:841–842

    Article  CAS  PubMed  Google Scholar 

  9. Dietrich T, Weisbach V, Seitz B et al (2008) Manufacture of autologous serum eye drops for out-patient therapy: cooperation between ophthalmic clinic and transfusion medicine department Ophthalmologe 105:1036–1038, 1040–1042

    Google Scholar 

  10. Hanisch KT, Neppert B, Geerling G (2005) Gas permeable scleral lenses as a conservative treatment option for extreme corneal ectasias and severe dry eye. Ophthalmologe 102:387–392

    Article  CAS  PubMed  Google Scholar 

  11. Hitchon CA, Alex P, Erdile LB et al (2004) A distinct multicytokine profile is associated with anti-cyclical citrullinated peptide antibodies in patients with early untreated inflammatory arthritis. J Rheumatol 31:2336–2346

    CAS  PubMed  Google Scholar 

  12. Höh H (2001) Lidkantenparallele konjunktivale Falten. In: Brewitt H, Zierhut M (Hrsg) Trockenes Auge. Heidelberg, Dr. Reinhard Kaden

  13. Jackson RS, Van Duyken SJ, Mc Cartney MD, Ubels JL (2001) The eicosanoid, 15- (S)-HETE, stimulates secretion of mucin-like glycoprotein by the corneal epithelium. Cornea 20:516–521

    Article  PubMed  Google Scholar 

  14. Jacobi C, Gottschalk K, Cursiefen C et al (ARVO, 2005) Organization of the subbasal nerves in a large group of control human corneas visualized with the Heidelberg Retina Tomograph (HRT II)

  15. Jacobi C, Wenkel H, Jacobi A et al (2007) Hepatitis C and ocular surface disease. Am J Ophthalmol 144:705–711

    Article  PubMed  Google Scholar 

  16. Johnson ME, Murphy PJ (2004) Changes in the tear film and ocular surface from dry eye syndrome. Prog Retin Eye Res 23:449–474

    Article  PubMed  Google Scholar 

  17. Jaksche A (2005) Undiluted versus diluted autologous serum eye drops: a prospective, randomized, double-blind study in patients with refractory dry eye-syndrome. DOG, Berlin

  18. Kojima T, Ishida R, Dogru M et al (2005) The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case-control study. Am J Ophthalmol 139:242–246

    Article  PubMed  Google Scholar 

  19. Liu L, Hartwig D, Harloff S et al (2005) An optimised protocol for the production of autologous serum eyedrops. Graefes Arch Clin Exp Ophthalmol 243:706–714

    Article  CAS  PubMed  Google Scholar 

  20. Luo L, Li DQ, Doshi A et al (2003) Experimental dry eye induced expression of inflammatory cytokines (IL-1α and TNF-α), MMP-9 and activated MAPK by the corneal epithelium. Invest Ophthalmol Vis Sci 44:E-Abstract 1026

    Google Scholar 

  21. Müller LJ, Marfurt CF, Kruse F, Tervo TMT (2003) Corneal nerves: structure, contents and function. Exp Eye Res 76:521–542

    Article  PubMed  Google Scholar 

  22. Murube J, Murube E (1996) Treatment of dry eye by blocking the lacrimal canaliculi. Surv Ophthalmol 40:463–480

    Article  CAS  PubMed  Google Scholar 

  23. Murube J (2003) Surgical treatment of dry eye. Orbit 22:203–232

    Article  CAS  PubMed  Google Scholar 

  24. Nichols KK, Yerxa B, Kellermann DJ (2004) Diquafosol tetrasodium: a novel dry eye therapy. Expert Opin Investig Drugs 13:47–54

    Article  CAS  PubMed  Google Scholar 

  25. Perry HD, Donnenfeld ED (2004) Dry eye diagnosis and management in 2004. Curr Opin Ophthalmol 15:299–304

    Article  PubMed  Google Scholar 

  26. Pflugfelder SC, Jones D, Ji Z et al (1999) Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögrens syndrome keratoconjunctivitis sicca. Curr Eye Res 19:201–211

    Article  CAS  PubMed  Google Scholar 

  27. Pflugfelder SC (2004) Perspective: Antiinflammatory therapies for dry eye. Am J Ophthalmol 137:337–342

    Article  PubMed  Google Scholar 

  28. Regenfuss B, Bock F, Bachmann B et al (2009) Topical inhibition of angiogenesis at the cornea. Safety and efficacy. Ophthalmologe 106:399–406

    Article  CAS  PubMed  Google Scholar 

  29. Scheuerle AF, Kruse FE (2004) Treatment of „dry eyes“. Med Monatsschr Pharm 27:199–207

    PubMed  Google Scholar 

  30. Schirra F, Ruprecht KW (2004) Dry eye. An update on epidemiology, diagnosis, therapy and new concepts. Ophthalmologe 101:10–18

    Article  CAS  PubMed  Google Scholar 

  31. Schirra F, Suzuki T, Richards SM et al (2005) Androgen control of gene expression in the mouse meibomian gland. Invest Ophthalmol Vis Sci 46:3666–3675

    Article  PubMed  Google Scholar 

  32. Seitz B, Grüterich M, Cursiefen C, Kruse FE (2005) Konservative und chirurgische Therapie der neurotrophen Keratopathie. Ophthalmologe 102:15–26

    Article  CAS  PubMed  Google Scholar 

  33. Smith RE (2005) The tear film complex: pathogenesis and emerging therapies for dry eyes. Cornea 24:1–7

    Article  PubMed  Google Scholar 

  34. Solomon A, Dursun D, Liu Z et al (2001) Pro-and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease. Invest Ophthalmol Vis Sci 42:2283–2292

    CAS  PubMed  Google Scholar 

  35. Stern ME, Pflugfelder SC (2004) Inflammation in dry eye. Ocul Surf 2:124–130

    PubMed  Google Scholar 

  36. Sullivan DA, Yamagami H, Liu M et al (2002) Sex steroids, the meibomian gland and evaporative dry eye. Adv Exp Med Biol 506:389–399

    CAS  PubMed  Google Scholar 

  37. Szodoray P, Alex P, Brun JG et al (2004) Circulating cytokines in primary Sjogren’s syndrome determined by a multiplex cytokine array system. Scand J Immunol 59:592–599

    Article  CAS  PubMed  Google Scholar 

  38. Szodoray P, Alex P, Jonsson MV et al (2005) Distinct profiles of Sjogren’s syndrome patients with ectopic salivary gland germinal centers revealed by serum cytokines and BAFF. Clin Immunol 117:168–176

    Article  CAS  PubMed  Google Scholar 

  39. Tomlinson A, Khanal S, Ramaesh K et al (2006) Tear film osmolarity: determination of a referent for dry eye diagnosis. IOVS 47:4309–4315

    Google Scholar 

  40. Tomlinson A, McCann L, Pearce EI (ARVO, 2009) Comparison of OcuSense and Clifton Nanolitre Osmometers. Dept. of Vision Sciences, Glasgow, Caledonian University, UK

  41. Weisbach V, Dietrich T, Kruse FE et al (2008) HIV and Hepatitis-B/C infections in patients donating blood for use as autologous serum eye drops. Br J Ophthalmol 91:1724–1542

    Article  Google Scholar 

  42. Wislon SE (2003) Inflammation: a unifying theory for the origin of dry eye syndrome. Manag Care 12:14–19

    Google Scholar 

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Danksagung

Sicca Forschungsförderung des Ressorts Trockenes Auge des BVA; Interdisziplinäres Zentrum für Klinische Forschung (IZKF) Erlangen (A9).

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Sicca-Spezialsprechstunde, Augenklinik mit Poliklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland

    C. Jacobi &  C. Cursiefen

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  1. C. Jacobi
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  2. C. Cursiefen
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Correspondence to C. Cursiefen.

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Jacobi, C., Cursiefen, C. Ophthalmologische Komplikationen beim Sjögren-Syndrom. Z. Rheumatol. 69, 32–40 (2010). https://doi.org/10.1007/s00393-009-0517-4

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  • DOI: https://doi.org/10.1007/s00393-009-0517-4

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