Deuter C M E, Klinik T, Müller M, Geerling G, Zierhut M
Department für Augenheilkunde, Universitätsklinikum Tübingen.
Ophthalmologe. 2010 May;107(5):427-34. doi: 10.1007/s00347-009-2065-3.
Secondary glaucoma represents a frequent complication especially in chronic forms of uveitis. Different immunological and mechanical alterations can be responsible for the elevation of intraocular pressure (IOP). To enable a tailored treatment strategy the diagnostic process has to include the search for characteristic findings which can be indicative for the underlying uveitis entity. Sometimes it can be difficult to distinguish inflammatory glaucoma from primary non-inflammatory forms of glaucoma as well as from steroid-induced elevation of IOP. Treatment of secondary glaucoma due to uveitis has to include not only medicinal and surgical lowering of IOP but also control of the inflammation, e.g. by immunosuppressive or antiviral drugs. Under normal conditions, beta-receptor antagonists and carbonic anhydrase inhibitors will represent first-line topical treatment. Besides cyclodestructive and filtrating procedures, the use of drainage implants has gained importance in the surgical treatment of secondary glaucoma due to intraocular inflammation.
继发性青光眼是一种常见的并发症,尤其是在慢性葡萄膜炎中。不同的免疫和机械性改变可导致眼压(IOP)升高。为了制定个性化的治疗策略,诊断过程必须包括寻找可指示潜在葡萄膜炎类型的特征性表现。有时,很难将炎性青光眼与原发性非炎性青光眼以及类固醇诱导的眼压升高区分开来。葡萄膜炎所致继发性青光眼的治疗不仅必须包括药物和手术降低眼压,还必须控制炎症,例如通过免疫抑制或抗病毒药物。在正常情况下,β受体拮抗剂和碳酸酐酶抑制剂将作为一线局部治疗药物。除了睫状体破坏术和滤过手术外,引流植入物在因眼内炎症引起的继发性青光眼的手术治疗中也变得越来越重要。