Diagnostic and therapeutic considerations in pediatric uveitis

SPEKTRUM DER AUGENHEILKUNDE(2024)

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摘要
Background The management of uveitis in children can be extremely challenging as they constitute a unique population of patients. The aim of this review is to summarize current knowledge encompassing the clinical findings, diagnostic work-up, and therapeutic approach of uveitis in children. Material and methods A thorough literature search was performed of PubMed. An additional search was made in Google Scholar to complete the collected items. Results Uveitis is less common in children than in adults, but it may be more complicated due to its often asymptomatic nature or due to the inability of children to express complaints. Uveitis in children can be chronic, persistent, recurrent, and resistant to conventional treatment. The most common type of uveitis in pediatric patients is anterior uveitis, whereas the prevalence of intermediate, posterior, and panuveitis depends on the ethnic group and geographical distribution. Although many cases of pediatric uveitis are idiopathic, the differential diagnosis requires awareness of etiologies, as uveitis in children may be associated with various systemic inflammatory disorders, infections, or masquerade syndromes. Ocular complications of uveitis include cataracts, synechiae formation, glaucoma or hypotony, band keratopathy, macular edema, epiretinal membrane, choroidal neovascular membranes, and retinal detachment. These complications are associated with not only the nature of the disease but also with the use of topical and systemic corticosteroids, leading to irreversible structural damage and visual loss. Conclusion The therapeutic approach depends on the etiologic factor and the individual characteristics of each patient. Regular monitoring is crucial for early detection of any complications of uveitis or even adverse effects from treatments. Multidisciplinary management is also vital for providing more holistic care to young patients and their families ensuring a better quality of life. This study aims to review the current literature on the management of uveitis in pediatric patients.
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关键词
Pediatric uveitis,Ocular inflammation,Multidisciplinary approach,Corticosteroids,Immunosuppression,Biologic agents
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