Keino Hiroshi, Watanabe Takayo, Taki Wakako, Nakayama Makiko, Nakamura Tomoko, Yan Kunimasa, Okada Annabelle A
Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
Department of Ophthalmology, Toyama University School of Medicine, Toyama, Japan.
Br J Ophthalmol. 2017 Apr;101(4):406-410. doi: 10.1136/bjophthalmol-2015-308194. Epub 2016 Jun 22.
To analyse clinical features, systemic associations, treatment and visual outcomes of uveitis in children and adolescents at a tertiary centre in Tokyo.
Clinical records of 64 patients under the age of 20 years who presented between 2001 and 2013 to the Ocular Inflammation Service of the Kyorin Eye Center, Tokyo were reviewed retrospectively.
Of the 64 patients, there was a predominance of girls (70%) and bilateral disease (81%). Mean age at presentation was 12.9 years (4-19 years). Mean follow-up was 46 months (3-144 months). Anterior uveitis was present in 56.3% of patients, panuveitis in 28.1% and posterior uveitis in 15.6%. No patients had intermediate uveitis. The most common diagnostic designation was unclassified uveitis (57.8%). Systemic associations were observed in 10.9% and no patients were diagnosed with juvenile idiopathic arthritis. Ocular complications were observed in 71.9% of patients, including optic disc hyperemia/oedema (40.6%), vitreous opacification (23.4%), posterior synechia (18.7%), increased intraocular pressure (17.1%) and cataract (14.1%). Six patients underwent intraocular surgery, five for cataract extraction and two for glaucoma control. Twelve patients (18.7%) received some form of systemic therapy either corticosteroids, immunosuppressive drugs or biologic agents. The percentage of eyes with a visual acuity of 1.0 or better was 87.1% at baseline, 91.3% at 6 months, 89.6% at 12 months and 87.5% at 36 months.
The majority of children and adolescents who presented to us with uveitis had bilateral disease and no systemic disease associations. Only one-fifth of patients required systemic therapy to control their ocular inflammation, and most eyes had a good visual outcome.
分析东京一家三级医疗中心儿童及青少年葡萄膜炎的临床特征、全身相关性、治疗及视力预后。
回顾性分析2001年至2013年间就诊于东京杏林眼科中心眼内炎症科的64例20岁以下患者的临床记录。
64例患者中,女性占多数(70%),双侧患病者占81%。就诊时的平均年龄为12.9岁(4 - 19岁)。平均随访时间为46个月(3 - 144个月)。56.3%的患者患有前葡萄膜炎,28.1%患有全葡萄膜炎,15.6%患有后葡萄膜炎。无患者患有中间葡萄膜炎。最常见的诊断类型为未分类葡萄膜炎(57.8%)。观察到10.9%的患者有全身相关性,且无患者被诊断为幼年特发性关节炎。71.9%的患者出现眼部并发症,包括视盘充血/水肿(40.6%)、玻璃体混浊(23.4%)、虹膜后粘连(18.7%)、眼压升高(17.1%)和白内障(14.1%)。6例患者接受了眼内手术,5例进行白内障摘除,2例进行青光眼控制。12例患者(18.7%)接受了某种形式的全身治疗,包括皮质类固醇、免疫抑制药物或生物制剂。基线时视力为1.0或更好的眼睛比例为87.1%,6个月时为91.3%,12个月时为89.6%,36个月时为87.5%。
向我们就诊的大多数儿童及青少年葡萄膜炎患者患有双侧疾病且无全身疾病相关性。只有五分之一的患者需要全身治疗来控制眼部炎症,且大多数眼睛视力预后良好。