Shivpuri Abhay, Turtsevich Inga, Solebo Ameenat Lola, Compeyrot-Lacassagne Sandrine
Rheumatology Department, Great Ormond Street Hospital for Children, London, United Kingdom.
Biomedical Research Centre, Great Ormond Street Hospital for Children, London, United Kingdom.
Front Pediatr. 2022 Aug 1;10:874711. doi: 10.3389/fped.2022.874711. eCollection 2022.
The challenges of childhood uveitis lie in the varied spectrum of its clinical presentation, the often asymptomatic nature of disease, and the evolving nature of the phenotype alongside normal physiological development. These issues can lead to delayed diagnosis which can cause significant morbidity and severe visual impairment. The most common ocular complications include cataracts, band keratopathy, glaucoma, and macular oedema, and the various associated systemic disorders can also result in extra-ophthalmic morbidity. Pediatricians have an important role to play. Their awareness of the various presentations and etiologies of uveitis in children afford the opportunity of prompt diagnosis before complications arise. Juvenile Idiopathic Arthritis (JIA) is one of the most common associated disorders seen in childhood uveitis, but there is a need to recognize other causes. In this review, different causes of uveitis are explored, including infections, autoimmune and autoinflammatory disease. As treatment is often informed by etiology, pediatricians can ensure early ophthalmological referral for children with inflammatory disease at risk of uveitis and can support management decisions for children with uveitis and possible underling multi-system inflammatory disease, thus reducing the risk of the development of irreversible sequelae.
儿童葡萄膜炎的挑战在于其临床表现的多样性、疾病通常无症状的特点,以及随着正常生理发育而不断演变的表型特征。这些问题可能导致诊断延迟,进而引发严重的发病率和严重的视力损害。最常见的眼部并发症包括白内障、带状角膜病变、青光眼和黄斑水肿,各种相关的全身性疾病也可能导致眼外发病率。儿科医生起着重要作用。他们对儿童葡萄膜炎的各种表现和病因的认识,为在并发症出现之前进行及时诊断提供了机会。幼年特发性关节炎(JIA)是儿童葡萄膜炎中最常见的相关疾病之一,但有必要认识到其他病因。在这篇综述中,探讨了葡萄膜炎的不同病因,包括感染、自身免疫性和自身炎症性疾病。由于治疗通常由病因决定,儿科医生可以确保对有葡萄膜炎风险的炎症性疾病儿童进行早期眼科转诊,并可以支持对患有葡萄膜炎和可能存在潜在多系统炎症性疾病的儿童的管理决策,从而降低不可逆后遗症发生的风险。