Zusammenfassung
Die essenzielle progressive Irisatrophie, das Chandler- und das Cogan-Reese-Syndrom
- von Scheie und Yanoff 1975 und Yanoff 1979 als iridocorneo-endotheliales Syndrom
bezeichnet - basieren auf einem pathologisch veränderten Hornhautendothel. Die Migrationsfähigkeit
dieses krankhaft veränderten Endothels über die Kammerwinkelstrukturen auf die Irisvorderfläche,
die Zonulafasern und vermutlich auch auf die Irisrückfläche erklärt die bei den Krankheitsbildern
in unterschiedlichem Ausprägungsgrad entstehende Pathomorphologie wie Hornhautödem,
Irisatrophie bis hin zu Kirchenfensterbildung, Pupillenverziehung, Irisnoduli und
Sekundärglaukom. Für die vorzugsweise einseitig auftretenden, ätiologisch bis heute
nicht geklärten Erkrankungen werden zunehmend Virusinfektionen (Herpes-simplex-, Epstein-Barr-Virus)
diskutiert. Die Therapie ist von dem jeweils im Vordergrund stehenden Symptomenkomplex
abhängig zu machen, d. h. Beherrschung des Sekundärglaukoms u./o. Behandlung der Hornhautdystrophie.
Abstract
The iridocorneal endothelial (ICE) syndrome includes progressive essential iris atrophy,
the Cogan-Reese syndrome, Chandler’s syndrome and mixed forms. The term ICE-S was
proposed by Scheie and Yanoff in 1975 and by Yanoff in 1979. The capacity of migration
of the abnormal corneal endothelial cell layer across the anterior chamber angle,
and on to the anterior surface of the iris, possible on to the back surface of the
iris and across the zonula fibers is responsible for corneal edema, secondary glaucoma,
nevi, noduli and atrophy of the iris, and pupillary distortion. The contraction of
the migrated membrane-like ICE tissue produces holes in the iris. The diseases are
usually unilateral in young patients. The etiology is still not clear. Theories include
membrane formation, low grade of inflammation and viral infection with Herpes simplex
or Epstein-Barr virus. Glaucoma and edema of the cornea are the main therapeutic problems.
Schlüsselwörter
progressive essenzielle Irisatrophie - Cogan-Reese-Syndrom - Chandler-Syndrom - Mischformen
- Ätiopathogenese - ICE-Zellen und -Gewebe - Differenzialdiagnosen - Therapie
Key words
Progressive essential iris atrophy - Cogan-Reese syndrome - Chandler’s syndrome -
mixed forms - etiology - ICE cells and tissue - differential diagnosis - therapy
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Prof. Dr. med. Jutta Herde
Klinik u. Poliklinik für Augenheilkunde, Medizinische Fakultät, Martin-Luther-Universität
Ernst-Grube-Straße 40
06120 Halle/Saale
Email: jutta.herde@medizin.uni-halle.de