Hettinga Ymkje M, Verhagen Fleurieke H, van Genderen Maria, de Boer Joke H
Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands; Bartiméus, Zeist, The Netherlands.
Acta Ophthalmol. 2014 Dec;92(8):798-804. doi: 10.1111/aos.12491. Epub 2014 Jun 29.
To investigate the clinical characteristics of childhood uveitis leading to visual impairment or blindness.
In this descriptive study, we reviewed data from the medical records of 58 children with visual impairment or blindness due to childhood uveitis, which were seen at an institute for visually impaired patients (Bartiméus) between January 1981 and December 2012, in a retrospective, cross-sectional manner.
Thirty-two of the 58 children (55%) were visually impaired and 26 (45%) were legally blind. Uveitis was posterior in 76% of all cases. Infectious uveitis represented 74% of all cases, of which 86% was congenital. Five patients (9%) had uveitis related to a systemic disease, and ten patients (17%) had idiopathic uveitis. There was a decrease in infectious causes over the last decades (p = 0.04) and an increase in idiopathic uveitis (p < 0.01), but the rate of children with posterior uveitis remained constant. There was an overall decrease in the number of children with uveitis referred to Bartiméus. The number of ocular complications at the time of intake was higher in children with acquired disease compared with congenital diseases (p < 0.01), as it was in children with non-infectious uveitis compared with infectious uveitis (p = 0.04). Most comorbidities that were noted were seen in children with infectious uveitis.
Most patients suffering from visual impairment or blindness due to childhood uveitis had posterior and/or infectious uveitis, mostly congenital. There is a shift in causes which shows a decrease in infectious causes and an increase in idiopathic causes.
探讨导致儿童视力损害或失明的葡萄膜炎的临床特征。
在这项描述性研究中，我们以回顾性横断面的方式，查阅了1981年1月至2012年12月期间在一家视力障碍患者机构（巴尔蒂默斯）就诊的58例因儿童葡萄膜炎导致视力损害或失明的儿童的病历数据。
58例儿童中，32例（55%）有视力损害，26例（45%）法定失明。所有病例中76%为后葡萄膜炎。感染性葡萄膜炎占所有病例的74%，其中86%为先天性。5例（9%）患有与全身性疾病相关的葡萄膜炎，10例（17%）患有特发性葡萄膜炎。在过去几十年中，感染性病因有所减少（p = 0.04），特发性葡萄膜炎有所增加（p < 0.01），但后葡萄膜炎患儿的比例保持不变。转诊至巴尔蒂默斯的葡萄膜炎患儿数量总体有所减少。与先天性疾病患儿相比，后天性疾病患儿就诊时眼部并发症的数量更多（p < 0.01），与感染性葡萄膜炎患儿相比，非感染性葡萄膜炎患儿也是如此（p = 0.04）。大多数记录到的合并症见于感染性葡萄膜炎患儿。
大多数因儿童葡萄膜炎导致视力损害或失明的患者患有后葡萄膜炎和/或感染性葡萄膜炎，大多为先天性。病因出现了转变，感染性病因减少，特发性病因增加。
