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土耳其南部一家三级转诊中心的儿童葡萄膜炎的临床特征。

Clinical features of childhood uveitis at a tertiary referral center in Southern Turkey.

机构信息

School of Medicine, Department of Ophthalmology, Cukurova University, 01330, Adana, Turkey.

School of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey.

出版信息

Int Ophthalmol. 2021 Jun;41(6):2073-2081. doi: 10.1007/s10792-021-01764-7. Epub 2021 Feb 24.

Abstract

PURPOSE

To report the epidemiology, etiology, ocular characteristics, management, and visual outcomes of pediatric uveitis patients in Southern Turkey.

METHODS

The clinical records of pediatric patients with a diagnosis of uveitis under the age of 16 years and followed up longer than 6 months were analyzed retrospectively.

RESULTS

The study included 102 patients and 173 affected eyes. The mean age at presentation was 11.4 ± 3.7 years. Uveitis was predominantly bilateral (69.6%), anterior (45.1%), and chronic (58.8%). The leading diagnoses were idiopathic uveitis (38.2%), pars planitis (19.6%), and juvenile idiopathic arthritis-associated uveitis (14.7%). Infectious uveitis accounted for 12.7%, and toxoplasmosis was the most common cause (10.8%). At least one complication was observed in 76.3% of the eyes, and optic disk edema (37%) was the most frequent. Corticosteroids were used in 97.1% and systemic immunomodulatory agents in 49% of the patients. Ocular surgery was performed in 17.3% of the eyes, and cataract extraction was the most common (8.7%). The mean BCVA was 0.39 ± 0.66 LogMAR at baseline and 0.25 ± 0.53 LogMAR at the last recorded visit.

CONCLUSION

Pediatric uveitis is a challenging disease that requires meticulous management. Anterior uveitis is the most frequent form. Despite a changing trend for an increase in diagnostic variety, idiopathic cases still constitute the majority. A significant number of patients receive systemic therapy, develop complications, and require surgical intervention. Early diagnosis and appropriate treatment might improve visual outcomes and reduce the risk of visual loss.

摘要

目的

报告土耳其南部儿科葡萄膜炎患者的流行病学、病因、眼部特征、治疗方法和视力结果。

方法

回顾性分析了年龄在 16 岁以下、随访时间超过 6 个月的儿科葡萄膜炎患者的临床记录。

结果

本研究纳入了 102 例患者的 173 只患眼。就诊时的平均年龄为 11.4±3.7 岁。葡萄膜炎主要为双侧(69.6%)、前葡萄膜炎(45.1%)和慢性(58.8%)。主要诊断为特发性葡萄膜炎(38.2%)、中间葡萄膜炎(19.6%)和青少年特发性关节炎相关葡萄膜炎(14.7%)。感染性葡萄膜炎占 12.7%,其中以弓形体病最为常见(10.8%)。76.3%的患眼至少出现一种并发症,视盘水肿(37%)最为常见。97.1%的患者使用皮质类固醇,49%的患者使用全身免疫调节剂。17.3%的患眼接受了眼部手术,其中白内障摘除最为常见(8.7%)。基线时平均 BCVA 为 0.39±0.66 LogMAR,最后一次随访时为 0.25±0.53 LogMAR。

结论

儿科葡萄膜炎是一种具有挑战性的疾病,需要精心管理。前葡萄膜炎是最常见的类型。尽管诊断种类呈增加趋势,但特发性病例仍占多数。相当数量的患者需要接受系统治疗、出现并发症并需要手术干预。早期诊断和适当治疗可能改善视力结果,降低视力丧失的风险。

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