Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania.
Ophthalmology, Boston University School of Medicine, Boston, Massachusetts.
J AAPOS. 2022 Jun;26(3):126.e1-126.e5. doi: 10.1016/j.jaapos.2022.03.004. Epub 2022 May 10.
To examine the incidence of uveitis in children prescribed prostaglandin analogs (PGAs) for glaucoma.
In this dual-center cohort study, the medical records of consecutive patients <18 years old treated with a PGA between January 1, 2012, and December 31, 2018, were reviewed retrospectively. Patients with all forms of glaucoma, including those with a prior history of uveitis, were included. Patients who had been on a PGA prior to their first recorded visit were excluded. Patient charts were reviewed for new or recurrent uveitis during the first year of PGA therapy.
A total of 103 children (147 eyes) were included, with a total PGA exposure of 1,352 child-months. Ninety-eight children (142 eyes) tolerated the PGA without an episode of uveitis. Five patients with a documented prior history of uveitis experienced a unilateral episode of uveitis. A review of their medical records identified prescribed or unscheduled decrease in topical steroids or immunosuppressive medication as the most likely cause of uveitis recurrence.
This study provides further evidence that PGAs are unlikely to induce uveitis in children being treated for glaucoma and suggests that this may also be true in those with a history of uveitis. We are unable to evaluate whether PGAs make recurrence more likely or the tapering of steroids more difficult.
研究儿童在使用前列腺素类似物（PGAs）治疗青光眼时发生葡萄膜炎的情况。
在这项双中心队列研究中，回顾性分析了 2012 年 1 月 1 日至 2018 年 12 月 31 日期间连续接受 PGA 治疗的年龄＜18 岁的患者的病历。纳入所有类型青光眼患者，包括有葡萄膜炎病史的患者。排除首次就诊前使用过 PGA 的患者。观察 PGA 治疗的第一年中是否出现新发或复发性葡萄膜炎。
共纳入 103 例患儿（147 只眼），PGA 总暴露时间为 1352 个儿童月。98 例患儿（142 只眼）耐受 PGA，无葡萄膜炎发作。5 例有葡萄膜炎病史的患儿出现单侧葡萄膜炎发作。回顾其病历，发现皮质类固醇药物或免疫抑制剂的规定或非计划减量是葡萄膜炎复发的最可能原因。
本研究进一步证明，PGAs 不太可能在治疗青光眼的儿童中诱发葡萄膜炎，且对于有葡萄膜炎病史的儿童可能也是如此。我们无法评估 PGAs 是否更易引起葡萄膜炎复发，或更易导致皮质类固醇药物减量困难。
