Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigrah, 160012, India.
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 2022 Apr;89(4):358-363. doi: 10.1007/s12098-021-03884-5. Epub 2021 Nov 3.
To describe the experience of managing chronic childhood uveitis from a tertiary care center in India.
All children diagnosed as chronic uveitis between January 2005 and December 2012 and on follow-up in Pediatric Rheumatology Clinic and Uveitis Clinic, were eligible for enrollment. Information regarding demographics, type of uveitis, treatment, complications, and surgical procedures was obtained from clinic records. All the enrolled patients were assessed for outcome prospectively and underwent a detailed ophthalmological examination to document visual acuity, refraction, intraocular pressure (IOP), slit lamp examination, fundus examination, and vitreous haze findings.
Sixty-seven children with chronic uveitis were enrolled in the study. Anterior uveitis was the commonest type seen in 45 children. Juvenile idiopathic arthritis (JIA) was the commonest known etiology and diagnosis of uveitis was made during routine screening in a majority of the JIA patients. No cause could be identified in 43% patients. After a mean follow-up period of 3.95 ± 1.99 y, only 16% eyes were in remission and off therapy. Prolonged oral glucocorticoids were required, besides other immunosuppressants, to control inflammation in 50% patients. Ocular complications were seen in 87% cases with posterior synechiae, band-shaped keratopathy and cataracts being the commonest complications.
Among patients with chronic uveitis, 43% had no identifiable cause. JIA was the commonest known cause. Significant ocular complications were common. Even after a mean follow-up of 3.95 ± 1.99 y, a vast majority continued to need immunosuppression for control of disease activity.
描述印度一家三级保健中心对慢性儿童葡萄膜炎的管理经验。
所有 2005 年 1 月至 2012 年 12 月间被诊断为慢性葡萄膜炎并在儿科风湿病诊所和葡萄膜炎诊所接受随访的儿童均符合入选条件。从病历中获取有关人口统计学、葡萄膜炎类型、治疗、并发症和手术程序的信息。所有入组患者均前瞻性评估结局，并进行详细的眼科检查，以记录视力、屈光度、眼内压（IOP）、裂隙灯检查、眼底检查和玻璃体混浊情况。
本研究共纳入 67 例慢性葡萄膜炎患儿。前葡萄膜炎是最常见的类型，见于 45 例患儿。幼年特发性关节炎（JIA）是最常见的已知病因，大多数 JIA 患者在常规筛查中做出葡萄膜炎诊断。43%的患者无法确定病因。平均随访 3.95±1.99 年后，仅有 16%的眼处于缓解状态且停止治疗。50%的患者需要长期口服糖皮质激素联合其他免疫抑制剂来控制炎症。87%的患者出现眼部并发症，后粘连、带状角膜病变和白内障是最常见的并发症。
在慢性葡萄膜炎患者中，43%的患者病因无法确定。JIA 是最常见的已知病因。常见严重的眼部并发症。即使在平均 3.95±1.99 年的随访后，绝大多数患者仍需要免疫抑制来控制疾病活动。
