Bou Rosa, Adán Alfredo, Borrás Fátima, Bravo Beatriz, Calvo Inmaculada, De Inocencio Jaime, Díaz Jesús, Escudero Julia, Fonollosa Alex, de Vicuña Carmen García, Hernández Victoria, Merino Rosa, Peralta Jesús, Rúa María-Jesús, Tejada Pilar, Antón Jordi
Pediatric Rheumatology Unit, Universitat de Barcelona, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, 08950, Barcelona, Spain,
Rheumatol Int. 2015 May;35(5):777-85. doi: 10.1007/s00296-015-3231-3. Epub 2015 Feb 6.
Uveitis associated with juvenile idiopathic arthritis (JIA) typically involves the anterior chamber segment, follows an indolent chronic course, and presents a high rate of uveitic complications and a worse outcome as compared to other aetiologies of uveitis. Disease assessment, treatment, and outcome measures have not been standardized. Collaboration between pediatric rheumatologists and ophthalmologists is critical for effective management and prevention of morbidity, impaired vision, and irreparable visual loss. Although the Standardization of Uveitis Nomenclature Working Group recommendations have been a great advance to help clinicians to improve consistency in grading and reporting data, difficulties arise at the time of deciding the best treatment approach in the individual patient in routine daily practice. For this reason, recommendations for a systematized control and treatment strategies according to clinical characteristics and disease severity in children with JIA-related uveitis were developed by a panel of experts with special interest in uveitis associated with JIA. A clinical management algorithm organized in a stepwise regimen is here presented.
与青少年特发性关节炎(JIA)相关的葡萄膜炎通常累及前房段,病程呈慢性迁延,与其他病因所致的葡萄膜炎相比,葡萄膜炎并发症发生率高且预后较差。疾病评估、治疗及预后指标尚未标准化。儿科风湿病学家与眼科医生之间的合作对于有效管理及预防发病、视力损害和不可修复的视力丧失至关重要。尽管葡萄膜炎命名标准化工作组的建议极大地推动了临床医生在分级和报告数据方面提高一致性,但在日常临床实践中为个体患者确定最佳治疗方法时仍存在困难。因此,一个对与JIA相关葡萄膜炎特别感兴趣的专家小组制定了根据儿童JIA相关葡萄膜炎的临床特征和疾病严重程度进行系统化控制和治疗策略的建议。本文介绍了一种按逐步方案组织的临床管理算法。