Clinical Pediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy.
Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease, and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Ocul Immunol Inflamm. 2023 Jan;31(1):175-184. doi: 10.1080/09273948.2021.2023582. Epub 2022 Feb 28.
Posterior idiopathic scleritis is the most common type of scleritis observed in childhood. Nevertheless, anterior and even necrotizing inflammatory scleritis may occur as well. Although less frequently than in the adult population, scleral inflammation can be associated with systemic disorders, which should be promptly recognized and treated to avoid both ocular and systemic complications. Hence, a multidisciplinary diagnostic work-up should be performed to rule out primarily infectious and autoimmune causes, such as viral and bacterial infections, anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, pediatric sarcoidosis, Behçet's disease and HLA-B27-associated diseases. Treatment of scleritis should aim to control ocular inflammation, relieve symptoms and prevent relapses, to avoid complications, preserve visual acuity and improve the child's quality of life. It should be tailored to the patient, considering the type and severity of scleritis, the possible identification of an infectious cause or the presence of an associated rheumatologic condition.
特发性后巩膜炎是儿童中最常见的巩膜炎类型。然而，也可能发生前巩膜炎甚至坏死性炎症性巩膜炎。尽管不如成人中常见，但巩膜炎炎症可与全身性疾病相关，应及时识别和治疗，以避免眼部和全身性并发症。因此，应进行多学科诊断检查，以排除主要的感染性和自身免疫性原因，如病毒和细菌感染、抗中性粒细胞胞质抗体 (ANCA) 相关性血管炎、儿童结节病、贝切特病和 HLA-B27 相关疾病。巩膜炎的治疗应旨在控制眼部炎症、缓解症状和预防复发，以避免并发症、保持视力和提高儿童的生活质量。应根据患者的情况进行调整，考虑巩膜炎的类型和严重程度、可能的感染原因或是否存在相关的风湿性疾病。
