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小儿葡萄膜炎概述

An Overview of Pediatric Uveitis.

作者信息

Tuğal-Tutkun İlknur

机构信息

Eye Protection Foundation Bayrampaşa Eye Hospital, İstanbul, Turkey;Department of Ophthalmology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.

出版信息

Turk Arch Pediatr. 2023 Jul;58(4):363-370. doi: 10.5152/TurkArchPediatr.2023.23086.

Abstract

Uveitis in childhood poses a distinct challenge, mainly because of the insidious onset and chronic course of intraocular inflammation in most cases, which may result in permanent visual loss due to delayed diagnosis and treatment. Although anterior uveitis, frequently associated with juvenile idiopathic arthritis, is the most common form of ocular involvement, idiopathic intermediate uveitis (pars planitis) is also a common uveitic entity in childhood. Posterior or panuveitis of a variety of noninfectious or infectious etiologies may be seen as well. Pediatric uveitis needs to be closely monitored since serious ocular complications such as intraocular pressure elevation, cataract, and macular edema may rapidly develop due to inadequately controlled inflammation and/or the use of corticosteroids. Methotrexate is generally the first- line corticosteroid-sparing agent, and adalimumab is the first-line biologic in refractory cases of noninfectious uveitis. A multidisciplinary approach is essential to monitor systemic disease associations, treatment response, and adverse events in children with uveitis.

摘要

儿童葡萄膜炎带来了独特的挑战,主要是因为在大多数情况下,眼内炎症起病隐匿且病程呈慢性,这可能因诊断和治疗延迟而导致永久性视力丧失。尽管前葡萄膜炎常与幼年特发性关节炎相关,是眼部受累最常见的形式,但特发性中间葡萄膜炎(睫状体平坦部炎)在儿童期也是常见的葡萄膜炎类型。各种非感染性或感染性病因引起的后葡萄膜炎或全葡萄膜炎也可能出现。由于炎症控制不当和/或使用皮质类固醇,儿童葡萄膜炎可能迅速出现严重的眼部并发症,如眼压升高、白内障和黄斑水肿,因此需要密切监测。甲氨蝶呤通常是一线的皮质类固醇节省剂,而阿达木单抗是难治性非感染性葡萄膜炎病例的一线生物制剂。多学科方法对于监测葡萄膜炎患儿的全身疾病关联、治疗反应和不良事件至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0688/10441137/2f9685b21867/tap-58-4-363_f001.jpg

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