Gunzinger Jeanne Martine, Kitay Alice, Meier Fabio, Böni Christian, Palmer Sarott Seraina, Simonsz-Tóth Brigitte, Gerth-Kahlert Christina
Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, Zurich, 8091, Switzerland.
Augenzentrum Witikon, Zurich, Switzerland.
J Ophthalmic Inflamm Infect. 2024 Dec 18;14(1):65. doi: 10.1186/s12348-024-00448-4.
Paediatric uveitis is a rare disease. It can affect any segment and have various etiologies, including infectious, autoimmune, and masquerade diseases. The pupose of this study is to analyse and present the demographic data in paediatric uveitis in a Swiss cohort. Knowledge of local demography may guide targeted work up and treatment.
Single center retrospective study from January 2012 to June 2022. Patients under 18 years of age with uveitis were eligible for inclusion. Demographics (age at first presentation, sex), ocular signs (affected eye segment, laterality, visual acuity; VA, Snellen, decimal, clinical course), and systemic finding were analysed. Frequencies and descriptive statistics were computed, non-parametric tests and odds ratio were applied for sample comparisons. Local ethics committee approved this study.
Data from 93 of 133 identified patients were available. 51% were female, mean age at first presentation was 12 years, 60% had bilateral disease. 68% were of non-infectious etiology. Most common identified etiology was toxoplasmosis (20%), followed by JIA (8%) and herpetic (8%). No associated infectious cause or systemic disease was found in 44% of the cases. Most presented with anterior uveitis (50%), followed by posterior (28%), intermediate (20%), and panuveitis (2%). 80% of anterior uveitis were non-infectious; 81% of posterior uveitis were infectious. Bilateral disease was strongly associated with non-infectious uveitis (93%), whereas unilateral disease was more likely to be of an infectious cause (70%); odds ratio = 31. Mean VA of affected eyes at first presentation was 0.79. VA was significantly worse in cases with infectious uveitis compared to non-infectious uveitis (p = 0.007). Nearly a third of affected eyes showed at least one complication. This did not differ between in non-infectious and infectious uveitis cases.
Bilateral disease is strongly suggestive of non-infectious uveitis. Unilateral and posterior disease is suggestive of an infectious cause, with toxoplasmosis being the most often diagnosed cause of uveitis in this cohort. Knowledge of demography is important for specialists to target workup and introduce treatment.
儿童葡萄膜炎是一种罕见疾病。它可累及任何部位，病因多样，包括感染性、自身免疫性和伪装综合征性疾病。本研究的目的是分析并呈现瑞士队列中儿童葡萄膜炎的人口统计学数据。了解当地人口统计学情况可能有助于指导针对性的检查和治疗。
对2012年1月至2022年6月进行单中心回顾性研究。纳入18岁以下的葡萄膜炎患者。分析人口统计学数据（首次就诊年龄、性别）、眼部体征（受累眼段、眼别、视力；视力、斯内伦视力表、小数视力、临床病程）和全身检查结果。计算频率和描述性统计量，应用非参数检验和比值比进行样本比较。本研究获当地伦理委员会批准。
在133例确诊患者中，有93例患者的数据可用。51%为女性，首次就诊的平均年龄为12岁，60%为双侧患病。68%为非感染性病因。最常见的确诊病因是弓形虫病（20%），其次是幼年特发性关节炎（JIA，8%）和疱疹性（8%）。44%的病例未发现相关感染病因或全身性疾病。大多数患者表现为前葡萄膜炎（50%），其次是后葡萄膜炎（28%）、中间葡萄膜炎（20%）和全葡萄膜炎（2%）。80%的前葡萄膜炎为非感染性；81%的后葡萄膜炎为感染性。双侧患病与非感染性葡萄膜炎密切相关（93%），而单侧患病更可能由感染引起（70%）；比值比 = 31。首次就诊时患眼的平均视力为0.79。与非感染性葡萄膜炎相比，感染性葡萄膜炎患者的视力明显更差（p = 0.007）。近三分之一的患眼至少出现一种并发症。非感染性和感染性葡萄膜炎病例之间无差异。
双侧患病强烈提示非感染性葡萄膜炎。单侧和后葡萄膜炎提示感染性病因，弓形虫病是该队列中最常诊断出的葡萄膜炎病因。了解人口统计学情况对专科医生进行针对性检查和开展治疗很重要。
