Department of Rheumatology, Rehabilitation, and Physical Medicine, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.
Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Clin Rheumatol. 2024 Dec;43(12):3855-3861. doi: 10.1007/s10067-024-07183-0. Epub 2024 Oct 27.
Uveitis is a major cause of visual impairment. Most uveitis cases have autoimmune etiology. Pediatric autoimmune uveitis may be associated with systemic diseases such as juvenile idiopathic arthritis or may arise as an isolated disorder. It may be accompanied by retinal vasculitis due to retinal microcirculation involvement. Nailfold capillaroscopy, a digital microscope, is a non-invasive tool for systemic microcirculation evaluation. We aimed to evaluate systemic microcirculation abnormalities in pediatric autoimmune uveitis. Twenty-five patients with pediatric autoimmune uveitis and 21 healthy children underwent detailed capillaroscopic evaluation. We assessed capillary density/mm, capillary morphology, capillary dimensions, and the presence or absence of microhemorrhages and avascular areas. The mean age of the study and control groups was 11.24 ± 3.03 and 9.9 ± 4.17 years, respectively. Most included patients had isolated uveitis and juvenile idiopathic arthritis (64% and 24%, respectively). The predominant uveitis subtype in the study was anterior uveitis (48%). A significant difference was found between cases and controls regarding mean capillary density (p-value = 0.0003) and the number of subjects having capillary density less than 7 (p-value = 0.002). Other capillaroscopic abnormalities did not show any significant difference between the studied groups. Mean capillary density did not correlate significantly with age, disease duration, or acute phase reactants. Children with autoimmune uveitis, whether isolated or as a part of systemic disease, may have systemic microcirculation involvement. Key Points • Idiopathic autoimmune uveitis is not always an isolated intraocular condition. • Systemic microcirculation involvement may occur in pediatric autoimmune uveitis, even in cases with isolated uveitis. • Nailfold capillaroscopy showed that capillary density in children with autoimmune uveitis is significantly reduced compared to healthy controls.
葡萄膜炎是视力损害的主要原因。大多数葡萄膜炎病例具有自身免疫病因。儿科自身免疫性葡萄膜炎可能与幼年特发性关节炎等系统性疾病有关，也可能作为一种孤立性疾病出现。它可能伴有视网膜血管炎，因为视网膜微循环受累。指垫毛细血管镜，一种数字显微镜，是评估系统性微循环的非侵入性工具。我们旨在评估儿科自身免疫性葡萄膜炎的系统性微循环异常。25 名儿科自身免疫性葡萄膜炎患者和 21 名健康儿童接受了详细的毛细血管镜评估。我们评估了毛细血管密度/mm、毛细血管形态、毛细血管尺寸以及微出血和无血管区域的存在或不存在。研究组和对照组的平均年龄分别为 11.24 ± 3.03 岁和 9.9 ± 4.17 岁。大多数纳入的患者患有孤立性葡萄膜炎和幼年特发性关节炎（分别为 64%和 24%）。研究中的主要葡萄膜炎亚型为前葡萄膜炎（48%）。病例组和对照组之间的平均毛细血管密度存在显著差异（p 值=0.0003），毛细血管密度小于 7 的受试者数量也存在显著差异（p 值=0.002）。其他毛细血管镜异常在研究组之间没有显示出任何显著差异。平均毛细血管密度与年龄、疾病持续时间或急性期反应物无显著相关性。自身免疫性葡萄膜炎患儿，无论是否孤立，或作为系统性疾病的一部分，可能存在全身微循环受累。关键点 • 特发性自身免疫性葡萄膜炎并不总是一种孤立的眼内疾病。 • 儿科自身免疫性葡萄膜炎可能存在全身微循环受累，即使是孤立性葡萄膜炎的病例。 • 指垫毛细血管镜显示，与健康对照组相比，自身免疫性葡萄膜炎患儿的毛细血管密度显著降低。
