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非感染性小儿葡萄膜炎患者的随访结果。

Follow-up Findings of Non-infectious Pediatric Uveitis Patients.

机构信息

Ankara Bilkent City Hospital, Children's Hospital, Clinic of Pediatric Rheumatology, Ankara, Turkey.

Şanlıurfa Training and Research Hospital, Clinic of Pediatric Rheumatology, Şanlıurfa, Turkey.

出版信息

Turk J Ophthalmol. 2021 Dec 28;51(6):351-357. doi: 10.4274/tjo.galenos.2021.38585.

Abstract

OBJECTIVES

In this study, we aimed to describe the demographic and clinical findings of children with uveitis at a tertiary pediatric rheumatology and ophthalmology center.

MATERIALS AND METHODS

A retrospective cross-sectional study was conducted with 46 patients who were diagnosed with uveitis before the age of 16 years and were followed regularly for at least 6 months between January 2013 and June 2019. Demographic data, uveitis characteristics, underlying diseases, systemic treatment modalities, drug side effects, complications, and surgical intervention were evaluated.

RESULTS

Eighty-three eyes of 46 patients were included in the study. The mean age at diagnosis of uveitis was 9.2±4.5 (1.6-15.6) years, and the mean uveitis follow-up period was 54±41 (6-191) months. Twenty-one patients (45.7%) had uveitis associated with rheumatologic diseases. Juvenile idiopathic arthritis was the most common disease (23.9%). Visual acuity was categorized as moderately impaired in 6 eyes (7.2%), severely impaired in 4 eyes (4.8%), and blindness in 1 eye (1.2%). Methotrexate (87%) was the most frequently used systemic immunosuppressive agent in treatment. Adalimumab (73.9%) was added to treatment in resistant cases. Thirty-five patients (76.1%) had complications in at least 1 eye secondary to uveitis or uveitis treatment. Posterior synechiae (11 eyes, 13.2%) was the most common complication during treatment.

CONCLUSION

In order to preserve visual acuity, pediatric uveitis should be recognized early and especially persistent/chronic cases should be started on effective systemic treatment immediately.

摘要

目的

本研究旨在描述一家三级儿科风湿病和眼科中心儿童葡萄膜炎的人口统计学和临床特征。

材料与方法

本研究为回顾性病例系列研究,纳入了 2013 年 1 月至 2019 年 6 月期间在 16 岁之前被诊断为葡萄膜炎且至少接受了 6 个月规律随访的 46 例患儿。评估了患儿的人口统计学数据、葡萄膜炎特征、基础疾病、全身治疗方式、药物副作用、并发症和手术干预。

结果

本研究纳入了 46 例患者的 83 只眼。葡萄膜炎的平均诊断年龄为 9.2±4.5(1.6-15.6)岁,葡萄膜炎的平均随访时间为 54±41(6-191)个月。21 例(45.7%)患者的葡萄膜炎与风湿性疾病相关。幼年特发性关节炎最常见(23.9%)。6 只眼(7.2%)视力中度受损,4 只眼(4.8%)视力严重受损,1 只眼(1.2%)失明。治疗中最常使用的全身免疫抑制剂是甲氨蝶呤(87%)。在耐药病例中加用阿达木单抗(73.9%)。35 例(76.1%)患者至少 1 只眼因葡萄膜炎或葡萄膜炎治疗出现并发症。后粘连(11 只眼,13.2%)是治疗期间最常见的并发症。

结论

为了保持视力,应早期识别儿童葡萄膜炎,特别是对于持续性/慢性病例应立即开始有效的全身治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6fc/8715655/73c0b2ee14ae/TJO-51-351-g1.jpg

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