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小儿交感性眼炎:综述。

Pediatric Pars Planitis: A Review.

机构信息

Department of Ophthalmology, Faculty of Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia.

Service of Uveitis and Retinal Diseases, Ankara Ulucanlar Eye Research Hospital, Ankara, Turkiye.

出版信息

Ocul Immunol Inflamm. 2023 Dec;31(10):1915-1929. doi: 10.1080/09273948.2023.2279683. Epub 2023 Dec 14.

Abstract

PURPOSE

To provide an overview of pediatric pars planitis.

METHODS

Narrative literature review.

RESULTS

Pars planitis refers to the idiopathic subset of intermediate uveitis in which there is vitritis along with snowball or snowbank formation occurring in the absence of an associated infection or systemic disease. It is thought to be a T-cell mediated disease with a genetic predisposition. Pars planitis accounts for 5-26.7% of pediatric uveitis cases. Presentation is commonly bilateral but asymmetric, often with insidious onset of floaters and blurred vision. Although pars planitis is known to be a benign form of uveitis in most cases, severe complications secondary to chronic inflammation may arise, with cystoid macular edema being the most common cause of visual morbidity. Mild vitritis in the absence of symptoms, vision loss, or macular edema may be observed. Patients with severe vitritis and/or associated vision-threatening complications require prompt aggressive treatment. A stepladder approach including corticosteroids, immunosuppressive agents, anti‑tumor necrosis factor‑alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis.

CONCLUSION

Timely diagnosis and adequate treatment of pediatric pars planitis and associated complications are crucial in order to improve visual outcomes.

摘要

目的

概述儿童交感性眼炎。

方法

叙述性文献回顾。

结果

交感性眼炎是指特发性中间葡萄膜炎的一个亚组,其特征为在无相关感染或系统性疾病的情况下出现玻璃体炎和雪球或雪堤样混浊。它被认为是一种与遗传易感性相关的 T 细胞介导的疾病。交感性眼炎占儿童葡萄膜炎病例的 5-26.7%。发病通常为双侧但不对称,常以隐匿性出现的飞蚊症和视力模糊为首发症状。虽然交感性眼炎在大多数情况下是一种良性的葡萄膜炎,但慢性炎症可能导致严重的并发症,其中最常见的致盲原因是黄斑囊样水肿。在没有症状、视力丧失或黄斑水肿的情况下,可能会观察到轻度的玻璃体炎症。对于严重的玻璃体炎症和/或伴有威胁视力的并发症的患者,需要及时进行积极治疗。阶梯式治疗方法包括皮质类固醇、免疫抑制剂、抗肿瘤坏死因子-α以及经睫状体平坦部玻璃体切割术和/或激光光凝术,是治疗交感性眼炎最常用的方法。

结论

及时诊断和充分治疗儿童交感性眼炎及其相关并发症对于改善视力结局至关重要。

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