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Uveitis pp 215-222 | Cite as

Kortikosteroide

  • W. Böke
Conference paper
Part of the Deutsche Ophthalmologische Gesellschaft Bericht über die 78. Zusammenkunft in Kiel 1980 book series (OPHTHALMOLOG, volume 78)

Zusammenfassung

Bei endogener Uveitis kann die Anwendung von Kortikosteroiden als Therapie der Wahl angesehen werden. Die Lokalgabe ist der systemischen Behandlung im allgemeinen vorzuziehen. Jede Kortikosteroid-Therapie kann sich nachteilig, ja gefährlich auswirken. An die systemischen Nebenwirkungen sei erinnert. Die potentiellen Risiken der lokalen Applikation, insbesondere der periokularen Injektion, müssen berücksichtigt werden. Wenn virulente Erreger das Krankheitsbild bestimmen oder beeinflussen wie bei Lues, Toxoplasmose, Tuberkulose, Mykosen, Zytomegaliekrankheit oder bei metastatischer Ophthalmie, muß die Steroidanwendung mit der Gabe von Medikamenten kombiniert werden, die gegen die verursachenden Keime gerichtet sind. Indikationen und Applikationen von Kortikosteroiden bei verschiedenen Formen der Uveitis werden diskutiert.

Corticosteroids

Summary

In endogenous uveitis the application of corticosteroids is considered to be the treatment of choice. In general, the topical application should be preferred to the systemic treatment. However, any corticosteroid therapy may turn out to be harmful or even dangerous. The systemic side effects of the drug are to be remembered. The potential hazards of its topical application, in particular those of periocular injections, must be respected. If virulent microbes determine the lesion or influence it, such as in syphilis, toxoplasmosis, tuberculosis, mykosis, cytomegalic disease or in metastatic endophthalmitis, the administration of corticosteroids has to be combined with drugs directed against the causing germe. Indications for steroid treatment in endogenous uveitis as well as the different ways of application are discussed.

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Literatur

  1. Aaberg TM, Cesarz TJ, Rytel MW (1972) Correlation of virology and clinical course of cytomegalovirus retinitis. Am J Ophthalmol 74:407.PubMedGoogle Scholar
  2. Andrasch RH, Pirofsky B, Burns RP (1978) Immuno suppressive therapy for severe chronic uveitis. Arch Ophthalmol 96:247.PubMedCrossRefGoogle Scholar
  3. Aronson SB, Sussman SJ, Moore E jr et al (1971) Corticosteroid therapy in metastatic endophthalmitis. Arch Ophthalmol (Chicago) 85:61.CrossRefGoogle Scholar
  4. Ballen PH, Loffredo FR, Painter B (1978) Listera endophthalmitis. Arch Ophthalmol 97:101.CrossRefGoogle Scholar
  5. Baum JL, Barza M, Lubar I, Onigman Ph (1975) The effect of corticosteroids in the treatment of experimental bacterial endophthalmitis. Am J Ophthalmol 80:513.PubMedGoogle Scholar
  6. Berger FF, Wenberg RS, Tessler HH et al (1979) Bilateral cytomegalovirus panuveitis after high-dose corticosteroid therapy. Am J Ophthalmol 88:1020.PubMedGoogle Scholar
  7. Böke W (1977) Periphere Uveo-Retinitis (Uveo-vitreo-retinales Entzündungssyndrom). Ber Dtsch Ophthalmol Ges 74:435.CrossRefGoogle Scholar
  8. Chisholm IH, Gass DM, Hutton WL (1976) The late stage of serpinginous Chorioiditis. Am J Ophthalmol 82:343.PubMedGoogle Scholar
  9. Chumbley LC, Robertson DM, Smith TF, Campbell RJ (1975) Adult cytomegalovirus inclusion retino-uveitis. Am J Ophthalmol 80:807.PubMedGoogle Scholar
  10. Cutler JE, Binder PS, Paul TO, Beamis JF (1978) Metastatic coccidioidal endophthalmitis. Arch Ophthalmol (Chicago) 96:689.CrossRefGoogle Scholar
  11. De Venecia G, Zu Rhein GM, Pratt MV, Kisken W (1971) Cytomegalic inclusion retinitis in an adult. Arch Ophthalmol 86:44.PubMedCrossRefGoogle Scholar
  12. Forster RK, Zachary IG, Cottingham AJ, Norton ED (1976) Further observations on the diagnosis cause and treatment of endophthalmitis. Am J Ophthalmol 81:52.PubMedGoogle Scholar
  13. Forster RK, Abott RL, Gelender H (1980) Management of infectious endophthalmitis. Ophthalmology 87:313.PubMedCrossRefGoogle Scholar
  14. Gamel JW, Allansmith MR (1974) Metastatic staphylococcal endophthalmitis presenting as chronic iridocyclitis. Am J Ophthalmol 77:454.PubMedGoogle Scholar
  15. Giles CL (1977) Uveitis in children. J Pediatr Ophthalmol 14:93.PubMedGoogle Scholar
  16. Godfrey WA, Smith RE, Kimura SJ (1977) Chronic cyclities: corticosteroid therapy. Trans Am Ophthalmol Soc 74:178.Google Scholar
  17. Hector RE (1978) Acute posterior multifocal placoid pigment epitheliopathy. Am J Ophthalmol 86:424.PubMedGoogle Scholar
  18. Hyndiuk RA, Reagan MG (1968) Radioactive depot-corticosteroid penetration into monkey ocular tissue. I. Retrobulbar and systemic administration. Arch Ophthalmol (Chicago) 80:499.CrossRefGoogle Scholar
  19. Hyndiuk RA (1969) Radioactive depot-corticosteroid penetration into monkey ocular tissue. II. Subconjunctival administration. Arch Ophthalmol (Chicago) 82:259.CrossRefGoogle Scholar
  20. Jacklin HN (1977) Acute posterior multifocal placoid pigment epitheliopathy and thyroiditis. Arch Ophthalmol (Chicago) 95:995.CrossRefGoogle Scholar
  21. Kaiser H (1977) Cortisonderivate in Klinik und Praxis. 7. Auflage, G. Thieme, Stuttgart.Google Scholar
  22. Kanski JJ (1977) Anterior uveitis in juvenile rheumatoid arthritis. Arch Ophthalmol (Chicago) 95:1794.CrossRefGoogle Scholar
  23. Kanter PJ, Goldberg MF (1974) Bilateral uveitis with exsudative retinal detachment. Arch Ophthalmol (Chicago) 91:13.CrossRefGoogle Scholar
  24. Kay ML, Yanoff M, Katowitz JA (1974) Development of sympathetic uveitis in spite of corticosteroid therapy. Am J Ophthalmol 78:90.PubMedGoogle Scholar
  25. Lissner GS, O’Grady R, Choromokos E (1978) Endogenous intraocular nocardia asteroides in Hodgkin’s disease. Am J Ophthalmol 68:388.Google Scholar
  26. Lyons DF (1977) Conservative management of central retinopathy. Trans Ophthalmol Soc UK 97:214.PubMedGoogle Scholar
  27. Makley ThA, Azar A (1978) Sympathetic ophthalmia. Arch Ophthalmol (Chicago) 96:257.CrossRefGoogle Scholar
  28. Masi RJ, O’Connor GR, Kimura SJ (1978) Anterior uveitis in geographic or serpingious Chorioiditis. Am J Ophthalmol 86:228.PubMedGoogle Scholar
  29. May DR, Peyman GA, Raichan M, Friedman M (1978) Metastatic peptostreptococcus intermedius endophthalmitis after dental procedure. Am J Ophthalmol 85:662.PubMedGoogle Scholar
  30. Meredig WE, Jentzen F, Hartmann F (1980) Der Einfluß okulär applizierter Glukokortikoide auf die Nebennierenrindenfunktion. Klin Monatsbl Augenheilkd 176:907.PubMedCrossRefGoogle Scholar
  31. Naidoff MA, Green WR (1975) Endogenous aspergillus endophthalmitis occurring after Kidney transplant. Am J Ophthalmol 79:502.PubMedGoogle Scholar
  32. Nicholson DH, Wolchok EB (1976) Ocular toxoplasmosis in an adult receiving long term corticosteroid therapy. Arch Ophthalmol 94:248.PubMedCrossRefGoogle Scholar
  33. Nozik RA (1977) Results of treatment of ocular toxoplasmosis with injectable corticosteroids. Trans Am Acad Ophthalmol 83:811.Google Scholar
  34. O’Connor GR (1976) Periocular corticosteroid injections: uses and abuses. Eye, Ear, Nose, Throat 55:83.Google Scholar
  35. O’Connor GR, Frenkel JK (1976) Dangers of steroid treatment in toxoplasmosis. Arch Ophthalmol 94:213.PubMedCrossRefGoogle Scholar
  36. O’Day DM, McKenna TJ, Elliott JH (1975) Ocular corticosteroid therapy. Systemic hormonal effects. Trans Am Acad Ophthalmol Otolaryngol 79:71.Google Scholar
  37. Ohno S, Char DH, Kimura JS, O’Connor GR (1977) Vogt-Koyanagi-Harada-syndrome. Am J Ophthalmol 83:735.PubMedGoogle Scholar
  38. Pau H (1968) Chorioretinitis exsudativa centralis (haemorrhagica). Klin Monatsbl Augenheilkd 152:348.PubMedGoogle Scholar
  39. Pau H (1979) Die zentrale seröse Retinitis oder Chorioretinitis (Retinopathia oder Chorioretinopathie) und die zentrale haemorrhagische Chorioretinitis (juvenile disciforme Makulaablösung, fokale hämorrhagische Chorioiditis, presumed Histoplasmosis). Klin Monatsbl Augenheilkd 175:634.PubMedGoogle Scholar
  40. Peyman GA (1980) Diskussion R. K. Forster et al. Management of infectious endophthalmitis. Ophthalmology 87:319.CrossRefGoogle Scholar
  41. Rao NA, Le Font RL (1977) Toxoplasmic retinochorioiditis. Arch Ophthalmol 95:273.PubMedCrossRefGoogle Scholar
  42. Ross WH, Sutton HFS (1980) Acquired syphilitic uveitis. Arch Ophthalmol (Chic) 98:496.CrossRefGoogle Scholar
  43. Ryan S, Maumenee A (1972) Acute posterior multifocal placoid pigment epitheliopathy. Am J Ophthalmol 74:1066.PubMedGoogle Scholar
  44. Saari M (1977) Toxoplasmic Chorioretinitis affecting the macula. Acta Ophthalmol (Kbh) 55:539.CrossRefGoogle Scholar
  45. Saari M, Vuorre I, Neiminen H, Räisänen S (1976) Acquired toxoplasmic Chorioretinitis. Arch Ophthalmol 94:1485.PubMedCrossRefGoogle Scholar
  46. Schildberg P, Wessing A (1975) Die fokale hämorrhagische Chorioiditis. Klin Monatsbl Augenheilkd 166:651.PubMedGoogle Scholar
  47. Schlaegel TF jr (1978) Ocular toxoplasmosis and pars planitis. Grune and Stratton, New York, San Francisco, London, p 334.Google Scholar
  48. Sher NA, Hill ChW, Eifrig DE (1977) Bilateral intraocular nocardia asteroides infection. Arch Ophthalmol 95:1415.PubMedCrossRefGoogle Scholar
  49. Smith RE (1980) Discussion to “Tuberculoma of the choroid”. Ophthalmology 87:257.Google Scholar
  50. Sundmacher R (1975) Zur Diagnose des Vogt-Koyanagi-Harada-Syndroms (Uveoenzephalitis). Klin Monatsbl Augenheilkd 166:540.PubMedGoogle Scholar
  51. Sundmacher R (im Druck) Die fokale Iritis durch Herpes simplex und Varizellen-Zoster-Virus. Ber Dtsch Ophthalmol Ges 78.Google Scholar
  52. Thiel HJ, Engelke W, Junker A (1978) Steriodkonzentration in der Vorderkammer des Kaninchens nach systematischer und lokaler Applikation 3-markierter Kortikosteroide. In: Böke W (ed) Kortikosteroide in der Augenheilkunde. J. F. Bergmann, München, S 167.Google Scholar
  53. Wendt H, Böke W (1978) Pharmakokinetische Untersuchungen mit Fluorcortolon am Auge der Kaninchen, Affen und Menschen. In: Böke W (ed) Kortikosteroide in der Augenheilkunde. J. F. Bergmann, München, S 159.Google Scholar
  54. West BC, Wilson JP (1980) Subconjunctival corticosteroid therapy complicated by hyperinfective strongyloidiasis. Am J Ophthalmol 89:854.PubMedGoogle Scholar
  55. Witmer R (1973) Glukokortikosteroide bei Uveitis. In: Böke W (ed) Kortikosteroide in der Augenheilkunde. DOG-Symposium 1972, J. F. Bergmann, München, S 216.Google Scholar
  56. Witmer R (1980) Sympathische Ophthalmie. Ber Dtsch Ophthalmol Ges 78:43.Google Scholar
  57. Yago K, Takashi M (1976) A case of miliary tuberculosis with various ocular findings (japanisca). Folia Ophthalmol Jap 27:1172.Google Scholar
  58. Yuasa T, Thoma N, Hirose Y et al (1972) Clinical studies on geographic disseminated Chorioiditis. Folia Ophthalmol Jap 23:1020Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1981

Authors and Affiliations

  • W. Böke
    • 1
  1. 1.Univ.-Augenklinik KielDeutschland

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