Abdwani Reem
Department of Child Health, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
Sultan Qaboos Univ Med J. 2009 Dec;9(3):247-56. Epub 2009 Dec 19.
Chronic uveitis is a rare, but potentially sight-threatening disease. The most common cause of chronic non-infectious uveitis is "idiopathic uveitis". However, some systemic diseases are associated with chronic uveitis in children and are discussed. Chronic uveitis merits special consideration in children. The unique differences in children are highlighted with special consideration for the diagnostic and therapeutic challenges encountered in their management. While corticosteroids remain the mainstay of initial therapy, a wide range of immunosuppressive agents have been used with variable success. The role of immonomodulatory agents such as methotrexate, cyclosproin and some of the new biologic agents such as etanecept, infliximab, adalimumab are reviewed. Successful outcomes may be achieved with appropriate immunosuppressant therapy when given early in the disease, although clinical trials are required to define the true efficacy of this strategy.
慢性葡萄膜炎是一种罕见但可能威胁视力的疾病。慢性非感染性葡萄膜炎最常见的病因是“特发性葡萄膜炎”。然而,一些全身性疾病与儿童慢性葡萄膜炎有关,对此进行了讨论。儿童慢性葡萄膜炎值得特别关注。文中强调了儿童的独特差异,并特别考虑了其治疗中遇到的诊断和治疗挑战。虽然皮质类固醇仍然是初始治疗的主要药物,但已使用了多种免疫抑制剂,效果各异。本文综述了甲氨蝶呤、环孢素等免疫调节剂以及依那西普、英夫利昔单抗、阿达木单抗等一些新型生物制剂的作用。在疾病早期给予适当的免疫抑制治疗可能会取得成功的结果,不过需要进行临床试验来确定这一策略的真正疗效。