摘要
目的分析儿童葡萄膜炎的临床特点、治疗效果、视力预后以及相关的全身疾病。方法采用回顾性病例分析方法，收集近4年间在天津市眼科医院诊治的16周岁及以下的儿童葡萄膜炎患者106例（165只眼），通过详细询问病史、眼部或全身检查，确定葡萄膜炎类型；分析其治疗效果、并发症发生情况和视力预后。结果在106例患者中，男45例，女61例（1：1．4）；平均发病年龄为（10．9±3．3）岁。急性发病18例（17．O％），慢性发病37例（34．9％），反复发作者51例（48．1％）。单眼发病47例，双眼发病59例。其中前葡萄膜炎52例（49．1％），中间葡萄膜炎31例（29．2％）、全葡萄膜炎15例（14．2％）和后葡萄膜炎8例（7．5％）。感染性葡萄膜炎15例（14．2％），特发性或免疫相关性炎症91例（85．8％）。根据病因分类，特发性前葡萄膜炎36例（34．0％），特发性中间葡萄膜炎31例（29．2％），特发性全葡萄膜炎13例（12．3％），合并幼年型关节炎10例（9．4％）和病毒性前葡萄膜炎5例（4．7％）。42例患儿58只眼（35．2％）出现眼部并发症，主要有虹膜后粘连（21．8％）、并发白内障（17．0％）、继发青光眼（9．7％）、角膜带状变性（9．7％）和黄斑囊样水肿（8．5％）。末次随访矫正视力低于0．5者45只眼（27．3％），低于0．1者16只眼（9．7％）。结论前葡萄膜炎是儿童时期常见的葡萄膜炎类型，其次为中间葡萄膜炎和全葡萄膜炎，后部葡萄膜炎较少见。多数患者表现为慢性特发性炎症，感染性葡萄膜炎较少见。儿童葡萄膜炎引发的各类并发症是致盲的主要原因。
Objective To describe the disease characteristics, the rate of complications and the visual outcome of pediatric uveitis under the age of 16 years in Tianjin, Northern of China. Methods The retrospective cases analysis methods were used. Of 106 cases （165 eyes） of pediatric uveitis were collected in Tianjin Eye Hospital from January 2005 to January 2009. The classifications of uveitis were determined by the history, detailed ocular and systemic examinations. The uveitis characteristics, complications, treatments and visual outcomes were analyzed. Results Total of 106 cases ofuveitis in children were collected. Males were 45 cases, females were 61 cases （1 ： 1.4）. The mean age at diagnosis was 10.9± 3.3 years old. The acute onset was 18 cases （17.0%）, the chronic onset was 37 cases （34.9%） and the relapsed was 51 cases （48.1%）. The unilateral onset was 47 cases （47 eyes）, the bilateral onset was 59 cases （118 eyes）. The most frequent clinical types ofuveitis included anterior uveitis 52 cases （49.1%）, intermediate uveitis 31 cases （29.2%）, panuveitis 15 cases （14.2%） and posterior uveitis 8 cases （7.5%）. The infectious uveitis was 15 cases （14.2%） and the non-infectious or idiopathic inflammation was 91 cases （85.8%）. Among the 106 cases of patients, idiopathic anterior uveitis was 36 cases （34.0%）, idiopathic intermediate uveitis was 31 cases （29.2%）, idiopathic panuveitis was 13 cases （12.3%）, combined with juvenile idiopathic arthritis was 10 cases （9.4%） and viral anterior uveitis was 5 cases （4.7%）. The complications occurred among the 58 eyes （35.2%）, there were posterior synechiae （21.8%）, complicated cataract （17.0%）, secondary glaucoma （9.7%）, band keratopathy （9.7%） and cystoid macular edema （8.5%）. The prevalence of visual impairment （less than 0.5 at the final visit） was 27.3% and the legal blindness （less than 0.1） was 9.7%. Conclusions Anterior uveitis is the most common type among the pediatric
出处
《中国实用眼科杂志》
CSCD
北大核心
2010年第9期982-985,共4页
Chinese Journal of Practical Ophthalmology
