Therapie von Sehnerverkrankungen – der aktuelle Stand

Zusammenfassung

Erkrankungen des Sehnervs haben vielfältige Ursachen und sind zusammen mit der Makuladegeneration die häufigste Ursache irreversibler Sehstörungen. Neben dem in dieser Arbeit nicht diskutierten Glaukom umfassen die wichtigsten Krankheitskategorien entzündliche, ischämische, kompressive, toxische, hereditäre und neoplastische Ursachen. Allen gemeinsam ist ihre Einmündung in Optikusatrophie, die auf molekularer Ebene teilweise noch nicht aufgeklärt ist, sowie ihre eingeschränkten Behandlungsoptionen. In dieser Übersichtsarbeit werden die wichtigsten Sehnerverkrankungen diskutiert, und es wird insbesondere kritisch auf die Verwendung von Kortikosteroiden bei Neuritis nervi optici, ischämischer Optikusneuropathie und traumatischer Optikusneuropathie eingegangen.

Abstract

Optic nerve diseases have various causes and are together with macular degeneration the most common causes of severe irreversible visual dysfunction. Apart from glaucoma, which will not be discussed in this review, the most common categories are inflammatory, ischaemic, compressive, toxic, hereditary, and neoplastic. They all share optic atrophy as a common end stage as well as the fact that treatment options are rather hampered, partially due to the fact that the molecular mechanisms of axonal loss are yet not understood well enough. This review covers most optic nerve diseases and places special emphasis on the use of corticosteroids in optic neuritis, ischaemic optic neuropathy and traumatic optic neuropathy.

Schlüsselwörter

Sehnerv - Optikusatrophie - Behandlung - Steroide

Key words

optic nerve - optic atrophy - treatment - steroids

Literatur

• 1 Trautner C, Haastert B, Richter B. et al . Incidence of blindness in southern Germany due to glaucoma and degenerative conditions.  Invest Ophthalmol Vis Sci. 2003;  44 1031-1034
• 2 Heijl A, Leske M C, Bengtsson B. et al . Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.  Arch Ophthalmol. 2002;  120 1268-1279
• 3 Beck R W, Gal R L, Bhatti M T. et al . Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial.  Am J Ophthalmol. 2004;  137 77-83
• 4 Trapp B D, Peterson J, Ransohoff R M. et al . Axonal transection in the lesions of multiple sclerosis.  N Engl J Med. 1998;  338 278-285
• 5 Steel D H, Waldock A. Measurement of the retinal nerve fibre layer with scanning laser polarimetry in patients with previous demyelinating optic neuritis.  J Neurol Neurosurg Psychiatry. 1998;  64 505-509
• 6 Trip S A, Schlottmann P G, Jones S J. et al . Retinal Nerve Fiber Layer Axonal Loss and Visual Dysfunction in Optic Neuritis.  Ann Neurol. 2005;  58 383-391
• 7 Frohman E, Costello F, Zivadinov R. et al . Optical coherence tomography in multiple sclerosis.  Lancet Neurol. 2006;  5 853-863
• 8 Kappos L, Antel J, Comi G. et al . Oral fingolimod (FTY720) for relapsing multiple sclerosis.  N Engl J Med. 2006;  355 1124-1140
• 9 McDonald W I, Compston A, Edan G. et al . Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis.  Ann Neurol. 2001;  50 121-127
• 10 Polman C H, Reingold S C, Edan G. et al . Diagnostic criteria for multiple sclerosis: 2005 revisions to the ”McDonald Criteria”.  Ann Neurol. 2005;  58 840-846
• 11 Lagrèze W A. Steroids for optic nerve diseases?.  Ophthalmologe. 2007;  104 517-520
• 12 Beck R W, Cleary P A, Anderson M M. et al . A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group.  N Engl J Med. 1992;  326 581-588
• 13 The 5-year risk of MS after optic neuritis. Experience of the optic neuritis treatment trial. Optic Neuritis Study Group.  Neurology. 1997;  49 1404-1413
• 14 Gould E S, Bird A C, Leaver P K. et al . Treatmenf of optic neuritis by retrobulbar injection of triamcinolone.  Br Med J. 1977;  1 1495-1497
• 15 Trauzettel-Klosinski Jr S, Diener H C, Dietz K. et al . The effect of oral prednisolone on visual evoked potential latencies in acute optic neuritis monitored in a prospective, randomized, controlled study.  Doc Ophthalmol. 1995;  91 165-179
• 16 Sellebjerg F, Nielsen H S, Frederiksen J L. et al . A randomized, controlled trial of oral high-dose methylprednisolone in acute optic neuritis.  Neurology. 1999;  52 1479-1484
• 17 Wakakura M, Mashimo K, Oono S. et al . Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG).  Jpn J Ophthalmol. 1999;  43 133-138
• 18 Vedula S, Brodney-Folse S, Gal R. et al . Corticosteroids for treating optic neuritis.  Cochrane database of systematic reviews (Online). 2007;  CD001430
• 19 Hickman S J, Kapoor R, Jones S J. et al . Corticosteroids do not prevent optic nerve atrophy following optic neuritis.  J Neurol Neurosurg Psychiatry. 2003;  74 1139-1141
• 20 Diem R, Hobom M, Maier K. et al . Methylprednisolone increases neuronal apoptosis during autoimmune CNS inflammation by inhibition of an endogenous neuroprotective pathway.  J Neurosci. 2003;  23 6993-7000
• 21 Lennon V A, Wingerchuk D M, Kryzer T J. et al . A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis.  Lancet. 2004;  364 2106-2112
• 22 Kidd D, Burton B, Plant G T. et al . Chronic relapsing inflammatory optic neuropathy (CRION).  Brain. 2003;  126 276-284
• 23 Jacob A, Weinshenker B G, Violich I. et al . Treatment of neuromyelitis optica with rituximab: retrospective analysis of 25 patients.  Arch Neurol. 2008;  65 1443-1448
• 24 Ruprecht K, Klinker E, Dintelmann T. et al . Plasma exchange for severe optic neuritis: treatment of 10 patients.  Neurology. 2004;  63 1081-1083
• 25 Bley T A, Uhl M, Carew J. et al . Diagnostic value of high-resolution MR imaging in giant cell arteritis.  Am J Neuroradiol. 2007;  28 1722-1727
• 26 Hayreh S S, Zimmerman B, Kardon R H. Visual improvement with corticosteroid therapy in giant cell arteritis. Report of a large study and review of literature.  Acta ophthalmologica Scandinavica. 2002;  80 355-367
• 27 Buono L M, Foroozan R, Sergott R C. et al . Nonarteritic anterior ischemic optic neuropathy.  Current opinion in ophthalmology. 2002;  13 357-361
• 28 Ischemic Optic Neuropathy Decompression Trial: twenty-four-month update.  Arch Ophthalmol. 2000;  118 793-798
• 29 Dickersin K, Manheimer E, Li T. Surgery for nonarteritic anterior ischemic optic neuropathy.  Cochrane database of systematic reviews (Online). 2006;  CD001538
• 30 Fraser S, Siriwardena D. Interventions for acute non-arteritic central retinal artery occlusion.  Cochrane database of systematic reviews (Online). 2002;  CD001989
• 31 Hayreh S S, Zimmerman M B. Non-arteritic anterior ischemic optic neuropathy: role of systemic corticosteroid therapy.  Graefes Arch Clin Exp Ophthalmol. 2008;  246 1029-1046
• 32 Newman N J, Scherer R, Langenberg P. et al . The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study.  Am J Ophthalmol. 2002;  134 317-328
• 33 Beck R W, Hayreh S S, Podhajsky P A. et al . Aspirin therapy in nonarteritic anterior ischemic optic neuropathy.  Am J Ophthalmol. 1997;  123 212-217
• 34 Salomon O, Huna-Baron R, Steinberg D M. et al . Role of aspirin in reducing the frequency of second eye involvement in patients with non-arteritic anterior ischaemic optic neuropathy.  Eye. 1999;  13 (Pt 3a) 357-359
• 35 Kupersmith M J, Frohman L, Sanderson M. et al . Aspirin reduces the incidence of second eye NAION: a retrospective study.  J Neuroophthalmol. 1997;  17 250-253
• 36 Mathews M K, Sergott R C, Savino P J. Pseudotumor cerebri.  Current opinion in ophthalmology. 2003;  14 364-370
• 37 Ahlskog J E, O’Neill B P. Pseudotumor cerebri.  Ann Intern Med. 1982;  97 249-256
• 38 Steinsapir K D. Treatment of traumatic optic neuropathy with high-dose corticosteroid.  J Neuroophthalmol. 2006;  26 65-67
• 39 Bracken M B, Shepard M J, Collins W F. et al . A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study.  N Engl J Med. 1990;  322 1405-1411
• 40 Bracken M B, Shepard M J, Holford T R. et al . Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study.  Jama. 1997;  277 1597-1604
• 41 Roberts I, Yates D, Sandercock P. et al . Effect of intravenous corticosteroids on death within 14 days in 10 008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial.  Lancet. 2004;  364 1321-1328
• 42 Yip C C, Chng N W, Au Kong K G. et al . Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy.  Eur J Ophthalmol. 2002;  12 309-314
• 43 Levin L A, Beck R W, Joseph M P. et al . The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study.  Ophthalmology. 1999;  106 1268-1277
• 44 Ohlsson M, Mattsson P, Svensson M. A temporal study of axonal degeneration and glial scar formation following a standardized crush injury of the optic nerve in the adult rat.  Restor Neurol Neurosci. 2004;  22 1-10
• 45 Ohlsson M, Westerlund U, Langmoen I A. et al . Methylprednisolone treatment does not influence axonal regeneration or degeneration following optic nerve injury in the adult rat.  J Neuroophthalmol. 2004;  24 11-18
• 46 Sheng Y, Zhu Y, Wu L. Effect of high dosage of methylprednisolone on rat retinal ganglion cell apoptosis after optic nerve crush.  Yan Ke Xue Bao. 2004;  20 181-186
• 47 Steinsapir K D, Goldberg R A, Sinha S. et al . Methylprednisolone exacerbates axonal loss following optic nerve trauma in rats.  Restor Neurol Neurosci. 2000;  17 157-163
• 48 Schargus M, Gramer E. Optic disc drusen.  Ophthalmologe. 2008;  105 693-710
• 49 Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen.  Surv Ophthalmol. 2002;  47 515-532
• 50 Puomila A, Hamalainen P, Kivioja S. et al . Epidemiology and penetrance of Leber hereditary optic neuropathy in Finland.  Eur J Hum Genet. 2007;  15 1079-1089
• 51 Spruijt L, Kolbach D N, Coo R F. et al . Influence of mutation type on clinical expression of Leber hereditary optic neuropathy.  Am J Ophthalmol. 2006;  141 676-682
• 52 Barnils de N, Mesa E, Munoz S. et al . Response to idebenone and multivitamin therapy in Leber’s hereditary optic neuropathy.  Archivos de la Sociedad Espanola de Oftalmologia. 2007;  82 377-380
• 53 Unsold A S, Rizzo 3rd  J F, Lessell S. Optic neuropathy after burns.  Arch Ophthalmol. 2000;  118 1696-1698
• 54 Klewin K M, Appen R E, Kaufman P L. Amaurosis and blood loss.  Am J Ophthalmol. 1978;  86 669-672
• 55 Sadun A A, Martone J F, Muci-Mendoza R. et al . Epidemic optic neuropathy in Cuba. Eye findings.  Arch Ophthalmol. 1994;  112 691-699
• 56 Lee A G. Neuroophthalmological management of optic pathway gliomas.  Neurosurg Focus. 2007;  23 E1
• 57 Pitz S, Becker G, Schiefer U. et al . Stereotactic fractionated irradiation of optic nerve sheath meningioma: a new treatment alternative.  Br J Ophthalmol. 2002;  86 1265-1268
• 58 Wilhelm H. Primary optic nerve tumours.  Curr Opinion Neurol. 2009;  22 11-18