Zusammenfassung
Die Konjunktiva ist als schützende Schleimhautbarriere des Sehorgans ein Teilabschnitt
des mit ca. 1,7 Quadratmetern größten menschlichen Organs der Haut. Die Bindehaut
unterliegt damit auch vergleichbaren Alterungsprozessen. Diese Alterungsprozesse lassen
sich auf biologisch bzw. genetisch bedingte Ursachen sowie auf Umwelt- und Lichteinflüsse
zurückführen. Hierdurch bedingte Störungen der Homöostase der konjunktivalen Schleimhautbarriere
tragen u. a. dazu bei, dass im hohen Alter häufiger Tumoren entstehen bzw. maligne
Transformationsprozesse einsetzen. Das Patientenalter zum Zeitpunkt der Befundbeurteilung
und der Tumormanifestation ist daher sowohl für die Klärung der Differenzialdiagnose
als auch die Behandlungsplanung hilfreich. In Abhängigkeit von den klinisch-relevanten
Leitbefunden und dem bisherigen Krankheitsverlauf sind die therapeutischen Möglichkeiten
individuell auszuwählen (inzisionale, exzisionale Biopsie, Kryotherapie, Chemo- oder
Radiotherapie, Exenteratio orbitae usw.). Im hohen Patientenalter sind geriatrische
Aspekte im Behandlungsmanagement zu beachten (Gewebebrüchigkeit, Wundheilungsstörungen,
Multimorbidität, eingeschränkte Patientenadherence).
Abstract
The conjunctiva as a mucous membrane provides a protective barrier to the eye. It
represents a small segment of the skin – the largest organ of the body, which has
a size of about 1.7 square metres. For this reason conjunctival ageing is affected
by equivalent processes as skin ageing. Common causes for these ageing processes are
biological and genetic effects as well as environmental conditions and exposure to
light. The resulting dysfunction in conjunctival homoeostasis and protective function
represent common factors which contribute to increased incidences of tumours and malignant
transformations in elderly patients. At the time of tumour manifestation the patient’s
age is an important parameter for differential diagnosis and regimen strategy. All
therapeutic options (surgical incision or excision, cryotherapy, chemo- or radiotherapy,
exenteratio orbitae etc.) have to be determined individually depending on clinically
relevant findings and previous anamnesis. Due to the patient’s age geriatric aspects
have to be considered in therapeutic management (tissue fragility, wound healing,
multimorbidity, decreased adherence).
Schlüsselwörter
Bindehaut - plastische Chirurgie - Pathologie - okuläre Tumoren - Anatomie - Expertenmeinung
Key words
conjunctiva - plastic surgery - pathology - ocular tumours - anatomy - experts opinion
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Prof. Dr. Frank HW Tost
Augenklinik am Universitätsklinikum, Ernst-Moritz-Arndt-Universität
Ferdinand-Sauerbruch-Str.
17475 Greifswald
Phone: ++ 49/38 34/86 59 23
Fax: ++ 49/38 34/86 59 50
Email: tost@uni-greifswald.de
