Laghmari M, Karim A, Guedira K, Ibrahimy W, Dahreddine M, Essakalli N H, Mohcine Z
Service d'Ophtalmologie A, Hôpital des Spécialités, Rabat, Maroc.
J Fr Ophtalmol. 2003 Jun;26(6):609-13.
Uveitis in children is rare: 3%-8% of all cases. It requires the same diagnostic and etiological processes as uveitis in adults, with additional difficulties at examination and a sometimes insidious progression.
Retrospective study of 20 cases of childhood uveitis from 1995 to 2000. All patients received an ophthalmologic examination and an etiological search, with specific and/or symptomatic treatment and follow-up lasting from 6 months to 5 years.
The 20 children presenting uveitis were 4-16 years old, with etiologies as follows: 8 cases of Behçet's disease, 2 cases of Vogt-Koyanagi-Harada's disease, 1 case of sarcoidosis, 1 case of uveitis associated with coeliac disease, 1 case of toxoplasmosis, 1 case of sympathetic ophthalmia, 1 case of uveitis with streptococcal infection, 3 cases of ocular toxocarosis, and 2 cases with unknown etiology. Treatment based on the etiological findings was started in the cases of toxoplasmosis and uveitis from streptococcal infection. The others were treated with high- and then digressive-doses of corticosteroids.
We have noted the high incidence of Behçet's disease in our series. Progression was marked by frequent recurrence for one case of Vogt-Koyanagi-Harada's syndrome and one case of toxoplasmosis. This study also revealed a few cases of complicated cataract.
Clinical characteristics, diagnosis, and treatment of uveitis in children are discussed.
儿童葡萄膜炎较为罕见,占所有病例的3%-8%。它需要与成人葡萄膜炎相同的诊断和病因学检查过程,但检查时会有额外困难,且病情有时进展隐匿。
对1995年至2000年期间20例儿童葡萄膜炎病例进行回顾性研究。所有患者均接受眼科检查和病因查找,并接受了特异性和/或对症治疗,随访时间为6个月至5年。
20例患葡萄膜炎的儿童年龄在4至16岁之间,病因如下:贝赫切特病8例,伏格特-小柳-原田病2例,结节病1例,与乳糜泻相关的葡萄膜炎1例,弓形虫病1例,交感性眼炎1例,链球菌感染所致葡萄膜炎1例,眼弓蛔虫病3例,2例病因不明。针对弓形虫病和链球菌感染所致葡萄膜炎,根据病因检查结果进行治疗。其他病例则先给予高剂量然后递减剂量的皮质类固醇治疗。
我们注意到在我们的病例系列中贝赫切特病的发病率较高。1例伏格特-小柳-原田综合征和1例弓形虫病的病情进展以频繁复发为特征。本研究还发现了几例复杂性白内障病例。
对儿童葡萄膜炎的临床特征、诊断和治疗进行了讨论。