Okuläre Herpesviridae-Infektionen – Labordiagnostik und Therapeutika

Infektionen mit Herpes-simplex-Virus Typ 1/2, Varizella-Zoster-Virus, Zytomegalievirus und Epstein-Barr-Virus sind von immerwährender Relevanz in der Augenheilkunde. Verschiedenste Untersuchungsverfahren stehen zur weiteren Abklärung zur Verfügung, falls es nicht möglich ist, die Diagnose mittels Anamnese und augenärztlicher Untersuchung zu stellen. Der Übersichtsartikel diskutiert indikationsspezifisch die Vor- und Nachteile der labormedizinischen Methoden. Serologische Verfahren aus peripherem Blut sind allgemein nicht zur Abklärung empfohlen. Die Polymerase-Ketten-Reaktion (PCR) ist gegenüber der Viruskultur als Standardmethode des Virusdirektnachweises sensitiver, schneller und präanalytisch unkomplizierter, weshalb aktuelle Studien zum Einsatz der PCR einen Schwerpunkt des Artikels bilden. Antivirale Therapeutika bilden das Rückgrat der konservativen Behandlung der durch Herpesviridae hervorgerufenen Krankheitsbilder. Einem Überblick über verfügbare Virustatika, ihre Indikationen, Wirkmechanismen und häufige unerwünschte Arzneimittelwirkungen (UAW) folgen eine Darstellung der entitätsspezifischen Studienlage sowie Fragen zum Umgang mit speziellen Patientengruppen (z. B. Kinder, Schwangere) und ein Ausblick auf mögliche zukünftige Therapieansätze.

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