Takkar Brijesh, Venkatesh Pradeep, Gaur Nripen, Garg Sat Pal, Vohra Rajpal, Ghose Supriyo
Retina and Uvea Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Int Ophthalmol. 2018 Oct;38(5):2061-2068. doi: 10.1007/s10792-017-0700-6. Epub 2017 Aug 31.
To study patterns of uveitis in Indian children and compare with data sets published earlier in the literature.
Consecutive patients below 16 years of age presenting to the uvea clinic of a tertiary eye care center were included prospectively through the period of July 2009-August 2013. Children with retinal vasculitis, exogenous endophthalmitis and masquerade syndromes were excluded from analysis. Uveitis was classified as per the nomenclature system adopted by the International Uveitis Study Group. Hemogram, Mantoux test and chest X-ray were done for each patient, along with tailored investigations and pediatric review as per clinical profile. Clinical pattern and etiology were the main outcome measures.
One hundred and thirty-four children were analyzed. Anterior uveitis (40%) was the commonest pattern followed by intermediate uveitis (25%), panuveitis (18%) and posterior uveitis (17%). Bilateral disease was present in 54%, 15% had infectious uveitis, 10% had granulomatous uveitis and 54% had idiopathic uveitis. Complications were present in half of the patients. Juvenile idiopathic arthritis (22), followed by toxoplasmosis (10) and tuberculosis (5), was the commonest etiology. Intermediate uveitis, non-granulomatous inflammation and older onset of disease had the high odds ratio of having idiopathic disease.
Patterns of pediatric uveitis can vary between regions from even within the same geopolitical region. Anterior uveitis is commonest, and juvenile idiopathic arthritis and toxoplasmosis are the most frequent etiologies. Diagnosis of pediatric ocular tuberculosis is more difficult than in adults and needs better and well-defined criteria.
研究印度儿童葡萄膜炎的发病模式，并与文献中先前发表的数据集进行比较。
前瞻性纳入2009年7月至2013年8月期间在一家三级眼科护理中心葡萄膜炎门诊就诊的16岁以下连续患者。视网膜血管炎、外源性眼内炎和伪装综合征患儿被排除在分析之外。葡萄膜炎根据国际葡萄膜炎研究组采用的命名系统进行分类。对每位患者进行血常规、结核菌素试验和胸部X线检查，以及根据临床情况进行的针对性检查和儿科评估。主要观察指标为临床模式和病因。
对134名儿童进行了分析。前葡萄膜炎（40%）是最常见的类型，其次是中间葡萄膜炎（25%）、全葡萄膜炎（18%）和后葡萄膜炎（17%）。54%为双侧疾病，15%为感染性葡萄膜炎，10%为肉芽肿性葡萄膜炎，54%为特发性葡萄膜炎。一半的患者出现了并发症。最常见的病因是幼年特发性关节炎（22例），其次是弓形虫病（10例）和结核病（5例）。中间葡萄膜炎、非肉芽肿性炎症和发病年龄较大的患者患特发性疾病的比值比高。
即使在同一地缘政治区域内，不同地区儿童葡萄膜炎的发病模式也可能有所不同。前葡萄膜炎最常见，幼年特发性关节炎和弓形虫病是最常见的病因。儿童眼部结核病的诊断比成人更困难，需要更好且明确的标准。
