Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Moorfields Eye Hospital, University College London, London, United Kingdom; Department of Ophthalmology, Bnei Zion Medical Center, Israel Institute of Technology-Technion, Haifa, Israel.
Am J Ophthalmol. 2019 Jun;202:72-78. doi: 10.1016/j.ajo.2019.02.011. Epub 2019 Feb 15.
To investigate the clinical course and visual outcome of macular edema (ME) in pediatric patients with chronic noninfectious uveitis.
Retrospective case series.
The databases of the uveitis clinics of 4 tertiary medical centers in Israel and the UK were searched for all children treated for uveitic ME in the years 2005-2015. Data were collected from the medical records as follows: demographics, diagnosis, visual acuity, clinical and imaging findings, and treatment given specifically for ME. Findings at baseline and at 3, 6, 12, and 24 months were evaluated.
The cohort included 25 children (33 eyes) of mean age 8.5 ± 3.4 years. The most common diagnosis was intermediate uveitis, in 14 children (7 idiopathic, 7 pars planitis). Uveitis was active at ME diagnosis in 28 eyes (84.8%). Median duration of follow-up was 48 months. Median time to resolution of ME was 6 months, with complete resolution in 25 eyes (75.8%) by 24 months. Baseline visual acuity was ≥20/40 in 8 eyes (24.2%), increased to 57.6% at 3 months (P < .0001), and remained stable thereafter. Treatment regimens included corticosteroids (systemically and/or locally), immunosuppression, and biologic therapies. No correlation was found between outcome and either structural characteristics of ME or specific treatment strategy.
The prognosis of pediatric uveitic ME is favorable despite its chronic course. Larger randomized controlled trials are needed to define differences among treatment regimens.
研究慢性非传染性葡萄膜炎患儿黄斑水肿（ME）的临床病程和视力结果。
回顾性病例系列研究。
检索以色列和英国的 4 家三级医疗中心葡萄膜炎诊所的数据库，寻找 2005 年至 2015 年间接受葡萄膜炎 ME 治疗的所有儿童。从病历中收集以下数据：人口统计学、诊断、视力、临床和影像学发现以及专门用于 ME 的治疗。评估基线和 3、6、12 和 24 个月时的发现。
该队列包括 25 名（33 只眼）平均年龄为 8.5 ± 3.4 岁的儿童。最常见的诊断是中间葡萄膜炎，其中 14 名儿童（7 名特发性，7 名睫状体平坦部炎）。在 28 只眼（84.8%）中，ME 诊断时葡萄膜炎活跃。中位随访时间为 48 个月。ME 缓解的中位时间为 6 个月，24 个月时有 25 只眼（75.8%）完全缓解。基线视力≥20/40 的有 8 只眼（24.2%），3 个月时增加到 57.6%（P <.0001），此后保持稳定。治疗方案包括皮质类固醇（全身和/或局部）、免疫抑制和生物疗法。结果与 ME 的结构特征或特定治疗策略之间未发现相关性。
尽管慢性病程，儿童葡萄膜炎性 ME 的预后仍然良好。需要更大规模的随机对照试验来确定治疗方案之间的差异。
