RAISE reference centre for rare diseases, IMAGINE Institute, Immunologie, Hématologie et Rhumatologie Pédiatrique, Hopital universitaire Necker-Enfants malades, Assistance Publique Hopitaux de Paris, Paris, France.
Paris-Descartes University, Paris, France.
RMD Open. 2019 Aug 5;5(2):e000933. doi: 10.1136/rmdopen-2019-000933. eCollection 2019.
To evaluate the demographics, aetiologies, complications, treatments and visual prognoses of chronic and recurrent non-infectious paediatric-onset uveitis in France.
Descriptive, retrospective and bicentric study in patients whose disease started before 17 and who were followed up in two centres from January 2010 to May 2017.
We included 147 patients with 268 affected eyes. Eighty-two had juvenile idiopathic arthritis-associated chronic uveitis, 58 were antinuclear antibody (ANA) positive and 24 were ANA negative, 36 had idiopathic uveitis, 9 had enthesitis-related arthritis-associated uveitis, 9 had sarcoidosis-associated uveitis and 11 had other inflammatory aetiologies. These patients cumulated 161 complications: ocular hypertension, cataract, band keratopathy, macular oedema, optic disk oedema and decreased visual acuity, including permanent visual loss for 31 patients. The most used treatments were corticosteroid (CS) eye drops (82%), systemic CSs (34%), methotrexate (58%) and biologics (38%). At the latest follow-up, 45 patients had achieved remission of uveitis without any treatment, 56 had inactive uveitis on topical steroids and 48 still had active uveitis.
Paediatric-onset uveitis are associated with a high rate of complications. However, following the introduction of biologics and particularly antitumour necrosis factor alpha antibodies, a significant proportion of uveitis became inactive on or even off treatment.
评估法国儿童慢性复发性非感染性葡萄膜炎的人口统计学、病因、并发症、治疗方法和视力预后。
这是一项描述性、回顾性的双中心研究，纳入了 2010 年 1 月至 2017 年 5 月期间在两个中心接受治疗且疾病起始于 17 岁之前的患者。
共纳入 147 例患者（268 只眼）。82 例为幼年特发性关节炎相关慢性葡萄膜炎，58 例抗核抗体（ANA）阳性，24 例 ANA 阴性，36 例为特发性葡萄膜炎，9 例为附着点相关关节炎相关葡萄膜炎，9 例为结节病相关葡萄膜炎，11 例为其他炎症病因。这些患者共发生 161 种并发症：眼压升高、白内障、带状角膜病变、黄斑水肿、视盘水肿和视力下降，其中 31 例患者视力永久性丧失。最常使用的治疗方法为皮质类固醇（CS）滴眼剂（82%）、全身 CS（34%）、甲氨蝶呤（58%）和生物制剂（38%）。在最近一次随访中，45 例患者在未接受任何治疗的情况下已实现葡萄膜炎缓解，56 例患者局部使用皮质类固醇治疗后葡萄膜炎处于静止状态，48 例患者仍存在活动性葡萄膜炎。
儿童期起病的葡萄膜炎常伴有较高的并发症发生率。然而，在生物制剂特别是抗肿瘤坏死因子-α抗体问世后，相当一部分葡萄膜炎患者在接受治疗或停药后即处于静止状态。
