Risk Factors for the Development of Cataract in Children with Uveitis

Blum-Hareuveni, Tamar; Seguin-Greenstein, Sophie; Kramer, Michal; Hareuveni, Guy; Sharon, Yael; Friling, Ronit; Sharief, Lazha; Lightman, Sue; Tomkins-Netzer, Oren

doi:10.1016/j.ajo.2017.02.023

Cited by 45 publications

(31 citation statements)

References 22 publications

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“…Most cases of OHT occurred in patients with JIA-associated or sarcoidosis-associated uveitis. Also, the rate of this complication increases in patients with a longer period between uveitis onset and the referral to the tertiary care centre, especially after several years of active uveitis, as described in other series 30 31…”

Section: Discussionmentioning

confidence: 68%

Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort

et al. 2019

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ObjectiveTo evaluate the demographics, aetiologies, complications, treatments and visual prognoses of chronic and recurrent non-infectious paediatric-onset uveitis in France.MethodsDescriptive, retrospective and bicentric study in patients whose disease started before 17 and who were followed up in two centres from January 2010 to May 2017.ResultsWe included 147 patients with 268 affected eyes. Eighty-two had juvenile idiopathic arthritis-associated chronic uveitis, 58 were antinuclear antibody (ANA) positive and 24 were ANA negative, 36 had idiopathic uveitis, 9 had enthesitis-related arthritis-associated uveitis, 9 had sarcoidosis-associated uveitis and 11 had other inflammatory aetiologies. These patients cumulated 161 complications: ocular hypertension, cataract, band keratopathy, macular oedema, optic disk oedema and decreased visual acuity, including permanent visual loss for 31 patients. The most used treatments were corticosteroid (CS) eye drops (82%), systemic CSs (34%), methotrexate (58%) and biologics (38%). At the latest follow-up, 45 patients had achieved remission of uveitis without any treatment, 56 had inactive uveitis on topical steroids and 48 still had active uveitis.ConclusionPaediatric-onset uveitis are associated with a high rate of complications. However, following the introduction of biologics and particularly antitumour necrosis factor alpha antibodies, a significant proportion of uveitis became inactive on or even off treatment.

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Section: Discussionmentioning

confidence: 68%

Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort

et al. 2019

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“…There have been no reports about the direct relationship between CAEBV and cataracts. However, cataract development is common among children with uveitis and is strongly related to the extent of inflammation recurrences [ 24 ]. Therefore, we believe the cataract of our patient may be secondary to her uveitis.…”

Section: Discussionmentioning

confidence: 99%

Chronic active Epstein–Barr virus infection manifesting as coronary artery aneurysm and uveitis

Xiao

Luo

et al. 2020

Virol J

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Background Chronic active Epstein–Barr virus (CAEBV) infection is a type of lymphoproliferative disorder characterized by chronic or recurrent infectious mononucleosis (IM)-like symptoms, which can have less-frequent clinical presentations. The prognosis of CAEBV is poor, and hematopoietic stem cell transplantation (HSCT) has been shown to be the only potentially effective treatment. In this article, we present a special CAEBV case of a patient who had no typical IM-like symptoms at the early stage, but manifested with severe and progressive coronary artery aneurysm (CAA), abdominal aortic lesions, and severe uveitis. These manifestations were uncommon features and could only be blocked by HSCT. Case presentation A 4-year-old girl with no special medical history complained of decreased vision for 10 months and cough after physical activities for three months. The blurred vision grew rapidly worse within one month, until only light perception remained. She was diagnosed with uveitis and cataract, and received prednisone and ciclosporin A treatment. However, her vision did not improve. Physical examination showed slight hepatosplenomegaly. Ultrasonic cardiogram showed bilateral CAA (5.0 mm and 5.7 mm for inner diameters), and abdominal CT scan revealed a thickened aortic wall, as well as stenosis and dilation of the segmental abdominal aorta. Other significant findings were increased EBV-DNA (3.29 × 104 copies/mL) from peripheral blood, positive EBV antibodies (EBV-CA-IgG, EBV-EA-IgA, and EBV-NA-IgG), and positive EBV-encoded small RNAs found by bone marrow biopsy. Based on her clinical manifestations and evidence for EBV infection, we diagnosed CAEBV. She received allogeneic HSCT, and the cataract operation was performed after HSCT. EBV-DNA could not be detected in peripheral blood after HSCT. Her CAAs did not progress, and uveitis was well controlled. Her vision recovered gradually over the 3 years after HSCT. Conclusions We present a rare CAEBV case of a patient who suffered from uncommon and severe cardiovascular and ocular involvement that was relieved by HSCT. Therefore, early recognition and diagnosis of CAEBV are of vital importance to improve its prognosis. In summary, this atypical CAEBV case could help us recognize similar cases more easily, make the right diagnosis as early as possible, and deliver proper and timely treatment.

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“…Posterior synechiae occur in up to 50 % of the eyes, whereby they are rarer in children with later-onset uveitis [35]. Posterior syne-chiae contribute to cataract development [37], for which reason a drug-based removal of the adhesions should always be sought. This is particularly effective while the adhesions are fresh and held in place by fibrin.…”

Section: Posterior Synechiamentioning

confidence: 99%

Childhood Uveitis

Thurau

2020

Klin Monbl Augenheilkd

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Childhood uveitis is an ophthalmological challenge, since on the one hand it often remains asymptomatic and difficult to detect, and on the other hand it often has a chronic course and is associated with a high risk of complications threatening the vision. The most important risk factors for childhood uveitis are underlying rheumatic diseases; recommendations for ophthalmological monitoring have been developed together with paediatric rheumatologists. Intermediate and posterior uveitis are rare in children. The therapy must effectively control inflammation and at the same time cause only minimal side effects. Since steroids in particular cause side effects frequently, an immunosuppressive therapy must be initiated early in an interdisciplinary cooperation with paediatric rheumatologists and parents with the goal of minimising steroids.

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Risk Factors for the Development of Cataract in Children with Uveitis

Cited by 45 publications

References 22 publications

Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort

Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort

Chronic active Epstein–Barr virus infection manifesting as coronary artery aneurysm and uveitis

Childhood Uveitis

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