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Klin Monbl Augenheilkd 2012; 229(7): 705-715
DOI: 10.1055/s-0032-1315021
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Klinisch-pathologische Korrelationen: Befunde des hinteren Augenabschnitts und der Orbita

Clinico-pathological Correlations: Posterior Compartment of the Eye and Orbit
M. C. Herwig
1   Universitäts-Augenklinik Bonn
,
K. U. Löffler
1   Universitäts-Augenklinik Bonn
,
J. R. Wells
2   Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
,
H. E. Grossniklaus
2   Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
› Institutsangaben
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Publikationsverlauf

eingereicht 04. März 2012

akzeptiert 04. Juni 2012

Publikationsdatum:
25. Juli 2012 (online)

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Zusammenfassung

Erkrankungen des hinteren Augenabschnitts und der Orbita sind durch histologische Charakteristika gekennzeichnet, die sich oft auch klinisch nachvollziehen lassen wie z. B. die ultrasonografisch nachweisbaren Verkalkungsherde beim Retinoblastom. In dem folgenden Beitrag werden histologische Befunde von Tumoren und anderen Erkrankungen des hinteren Augenabschnitts und der Orbita vorgestellt und mit dem klinischen Erscheinungsbild sowie bildgebenden Verfahren korreliert: Aderhaut-/Ziliarkörpermelanom, Aderhautnävus, Aderhautmetastasen, Hämangiom der Aderhaut, Retinoblastom, Morbus Coats, sympathische Ophthalmie, pleomorphes Adenom der Tränendrüse, Dakryoadenitis, Lymphom, Rhabdomyosarkom, Langerhans-Zellhistiozytose, orbitale Metastasen und Phthisis bulbi. Die Histopathologie ist nach wie vor der Goldstandard für die definitive Diagnose vieler Erkrankungen. Insbesondere für Augenärzte in der Weiterbildung ist es wichtig, frühzeitig mit klinisch-pathologischen Korrelationen in Berührung zu kommen. Vom Verständnis pathophysiologischer Zusammenhänge, das dabei sehr bildlich vermittelt werden kann, profitiert jeder klinisch tätige Augenarzt. Operativ tätige Augenärzte können die postoperativen Wundheilungsvorgänge am histologischen Präparat studieren. Eine enge Zusammenarbeit zwischen Klinikern und Ophthalmopathologen führt zudem nicht nur zu einer optimierten Materialaufbereitung und Diagnostik, sondern auch zu einer verbesserten Patientenvor- und -nachsorge. Diese augenärztliche Kompetenz sollte auch weiterhin gefördert und unterstützt werden, um die Qualität der augenärztlichen Versorgung auf einem hohen Niveau zu halten.

Abstract

Diseases of the posterior compartment and the orbit are characterised by histological findings, most of which can be reproduced clinically. Examples are the examination of calcifications in retinoblastoma by ultrasonography. In the present review, histological findings of tumour and other diseases of the posterior ocular compartment and the orbit are presented and correlated with the clinical pictures and imaging techniques: uveal melanoma, choroidal nevus, choroidal metastases, choroidal hemangioma, retinoblastoma, Coatʼs disease, sympathetic ophthalmia, pleomorphic adenoma (benign mixed tumour) of the lacrimal gland, dacryoadenitis, lymphoma, rhabdomyosarcoma, Langerhans cell histiocytosis, orbital metastases, and phthisical eyes. Histopathology is usually the gold standard for a definitive diagnosis. It is very important for residents and those in training to become familiar with clinico-pathological correlations as these provide insight in pathophysiological processes. Regarding ophthalmic surgery, ophthalmic pathology offers the possibility to study wound healing and complications. A close collaboration between clinicians and ocular pathologists allows for an optimised processing of the submitted tissue and diagnosis. Thus, pre- and postoperative care can also be improved. This outstanding knowledge that ophthalmologists have gained over the last decades and beyond, should be preserved and passed on to the next generations in order to maintain a high standard in ophthalmological care.

Schlüsselwörter

Pathologie - Orbita - okuläre Tumoren

Key words

pathology - orbit - ocular tumours
 

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