CAJ | 학술논문

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(17.0%),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%)和后匍萄膜炎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只跟(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.
목적 분석인동포도막염적림상특점、치료효과、시력예후이급상관적전신질병.방법 채용회고성병례분석방법,수집근4년간재천진시안과의원진치적16주세급이하적인동포도막염환자106례(165지안),통과상세순문병사、안부혹전신검사,학정포도막염류형;분석기치료효과、병발증발생정황화시력예후.결과 재106례환자중,남45례,녀61례(1:1.4);평균발병년령위(10.9±3.3)세.급성발병18례(17.0%),만성발병37례(34.9%),반복발작자51례(48.1%).단안발병47례,쌍안발병59례.기중전포도막염52례(49.1%),중간포도막염31례(29.2%)、전포도막염15례(14.2%)화후포도막염8례(7.5%).감염성포도막염15례(14.2%),특발성혹면역상관성염증91례(85.8%).근거병인분류,특발성전포도막염36례(34.0%),특발성중간포도막염31례(29.2%),특발성전포도막염13례(12.3%),합병유년형관절염10례(9.4%)화병독성전포도막염5례(4.7%).42례환인58지근(35.2%)출현안부병발증,주요유홍막후점련(21.8%)、병발백내장(17.0%)、계발청광안(9.7%)、각막대상변성(9.7%)화황반낭양수종(8.5%).말차수방교정시력저우0.5자45지안(27.3%),저우0.1자16지안(9.7%).결론 전포도막염시인동시기상견적포도막염류형,기차위중간포도막염화전포도막염,후부포도막염교소견.다수환자표현위만성특발성염증,감염성포도막염교소견.인동포도막염인발적각류병발증시치맹적주요원인.
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 fiom 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 of uveitis 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 of uveitis 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 36cases (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 uveitis,the following are intermediate uveitis and panuveitis, the posterior uveitis is uncommon. Most patients are chronic or idiopathic inflammation. The infectious uveitis is uncommon. The complications of uveitis are the main cause of the blindness.