Die Blut-Augen-Schranken und ihre Störungen: Anatomie, Physiologie, Pathologie

Zusammenfassung

Die Blut-Augen-Schranken, bestehend aus Blut-Kammerwasser-Schranke (BKS) und Blut-Retina-Schranke (BRS), bilden eine selektiv permeable physiologische Barriere zwischen der stark vaskularisierten Uvea und dem Vorderkammer- und Glaskörperraum sowie der sensorischen Netzhaut aus. Diese Barrieren schützen vor dem Eindringen von Toxinen und Krankheitserregern aus dem Blutkreislauf, kontrollieren den Protein- und Flüssigkeitshaushalt und tragen aktiv zum Erhalt des okulären Immunprivilegs bei. Morphologisches Korrelat der Blut-Augen-Schranken sind Tight Junctions zwischen benachbarten Endothel- und Epithelzellen, die den Interzellularraum abdichten und eine unkontrollierte parazelluläre Diffusion von Molekülen verhindern. Die BKS besteht aus den Tight Junctions der Endothelzellen der Irisgefäße, der Endothelzellen der Innenwand des Schlemm-Kanals und der Epithelzellen des unpigmentierten Ziliarepithels; die BRS setzt sich aus den Tight Junctions der Endothelzellen der retinalen Gefäße (innere BRS) und des retinalen Pigmentepithels (äußere BRS) zusammen. Während endotheliale Schranken eine absolute immunologische Barriere darstellen, fungieren epitheliale Schranken als immunregulatorische „Gatekeeper“, die Leukozyten kontrolliert passieren lassen. Funktionelle Störungen der Blut-Augen-Schranken, klinisch messbar mittels Laser-Flare-Photometrie oder Fluorophotometrie, können im Rahmen traumatischer, entzündlicher und infektiöser Prozesse auftreten, sind aber auch an der Pathophysiologie chronischer Erkrankungen des vorderen Augenabschnitts, wie Glaukom, und der Netzhaut, wie diabetischer Retinopathie und altersbedingter Makuladegeneration, zentral beteiligt.

Schlüsselwörter

Blut-Augen-Schranken - Blut-Kammerwasser-Schranke - Blut-Retina-Schranke - Tight Junctions - diabetische Retinopathie - altersbedingte Makuladegeneration

Publication History

Received: 05 January 2023

Accepted: 21 March 2023

Article published online:
19 May 2023

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