Uveitis in Children and Adolescents

Cunningham, Emmett T.; Smith, Justine R.; Tuğal-Tutkun, İlknur; Rothová, Aniki; Zierhut, Manfred

doi:10.1080/09273948.2016.1204777

Cited by 16 publications

(9 citation statements)

References 73 publications

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“…Uveitis in pediatric rheumatic diseases is identified as an inflammatory event of the uvea of the iris, choroid, and retina. Although rheumatic diseases are partially common during childhood, the rheumatic disease-related uveitis is an uncommon finding in young people accounting for approximately5 to 10% of all individuals with uveitis [1,2]. Despite its low prevalence, potential complications of uveitis as well as high disease burden present the disease management as a considerable challenge.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Jari

Shiari

Salehpour

et al. 2020

Orphanet J Rare Dis

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Background: Despite the low prevalence of uveitis in pediatric rheumatic diseases, potential problems as well as high disease burden can complicate its management. In this review, we systematically assessed the epidemiological, etiological, and managerial aspects of uveitis in pediatric rheumatic diseases. Methods: This current study was conducted in accordance with the established methods and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). We searched the manuscript databases, including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane for all eligible studies in line with the considered keywords. We also conducted the statistical analysis using the Stata software. Results: Considering studies focusing on uveitis in Juvenile Idiopathic Arthritis (JIA) yielded a pooled prevalence of 11.8% (95%CI: 11.2 to 12.4%) for uveitis following JIA. In this regard, the prevalence rate of uveitis related to Behçet , s disease and Systemic Lupus Erythematosus (SLE(was estimated to be 15.0 and 0.8%, respectively. The pooled response rate to Adalimumab and Infliximab was estimated to be 68.0% (95%CI: 65.4 to 70.6%), 64.7% (95%CI: 59.8 to 69.3%), respectively. The documents for the systematical assessment of other biological medications (e.g. Tocilizumab, Daclizumab and Rituximab) were inadequate; however, the mean response rate for these drugs was 59, 75 and 80%, respectively. Our meta-analysis showed a pooled response rate of 40.0% (95%CI, 36.0% to 44.2) to Methotrexate. Significant heterogeneity and significant diffusion bias were demonstrated by reviewing studies. Conclusions: The pooled prevalence of uveitis in pediatric rheumatic diseases widely varied based on the underlying disease requiring more investigations in different subtypes of rheumatic diseases. The biologic medications, especially Adalimumab are the most effective treatments for uveitis in pediatric rheumatic diseases; however, a combination of the safe, available alternatives is preferred to achieve the most desirable treatment response.

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Section: Introductionmentioning

confidence: 99%

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Jari

Shiari

Salehpour

et al. 2020

Orphanet J Rare Dis

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“…Необходимо отметить, что в сыворотке крови больных ХПУ различной этиологии отмечается значительное повышение уровня TNF, в то время как его концентрация во внутриглазной жидкости не отличается от таковой у здоровых добровольцев [12,14,42,60,61,64]. В ходе экспериментального моделирования ХПУ на мышах выявлено, что нейтрализация TNF сопровождается уменьшением выраженности и тяжести течения хориоретинального воспаления, а дефицит данного фактора и вовсе приводит к резистентности развития увеита [57].…”

Section: иммунологические изменения при хроническом периферическом ув...unclassified

“…На него приходится до 26,7% в структуре педиатрических увеитов и до 31% среди пациентов всех возрастов [6,9,13,31,35,43,44,46,80,82]. По данным литературы, среди пациентов с ХПУ преобладают женщины [8,12,15,46,53,61], и в 80-90% случаев воспаление поражает оба глаза [11,44,47,51,53]. Течение заболевания характеризуется скудными клиническими проявлени-ями, которые самими пациентами в большинстве случаев расцениваются как признаки зрительного утомления.…”

Section: Introductionunclassified

“…Течение заболевания характеризуется скудными клиническими проявлени-ями, которые самими пациентами в большинстве случаев расцениваются как признаки зрительного утомления. Однако опасность ХПУ заключается в высоком риске развития осложнений в отдаленные сроки от начала болезни, таких как осложненная катаракта, офтальмогипертензия, кистозный отек сетчатки макулярной области, отслойка сетчатки [8,12,15,20,31,37,41,46,47,50,53,65,82].…”

Section: Introductionunclassified

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Modern etiological and pathogenetic aspects of chronic peripheral uveitis

2022

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Intermediate uveitis is among most severe forms of endogenous uveitis which is more common in young people, being characterized by minimal clinical manifestations at early stages of the disorder. A significant and, sometimes, irreversible decrease in visual acuity is associated with development of long-term complications of chronic cintermediate uveitis (CIU), i.e., complicating cataracts (in up to 57% of the cases), cystic maular edema developing at a frequency of up to 31%), as well as ophthalmic hypertension and glaucoma (up to 16% of the patients). The incidence rate of CIU is 1.5 per 100,000 per year. The eye, despite its high immune privilege, is susceptible to infectious and inflammatory diseases. Clinical and histopathological data suggest autoimmune origin of CIU associated with possible response to some endogenous antigen of unknown origin. The main effectors of inflammation in peripheral chorioretinal structures are CD4+T lymphocytes, which are found in paravasal infiltrates and vitreoretinal exudates in CIU. An important role in CIU pathogenesis is attributed to IL-6 and IL-8, TNFá, vascular endothelial growth factor (VEGF), and micro-RNAs, which show increased expression in most CIU patients. Impaired state of intestinal bacterial microbiome is a potential trigger of intraocular inflammation. Genetic predisposition for CIU was also revealed, due to polymorphisms of human leukocyte antigens and some other genes. It is necessary to expand and deepen our knowledge on the disease pathogenesis, in order to develop effective pharmacological treatment of CIU. The article is review of literature discussing the modern scientific ideas concerning etiology and mechanisms of the CIU development.

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“…In contrast, children with anterior uveitis should undergo routine antinuclear antibody testing to screen for juvenile idiopathic arthritis. 25,27…”

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confidence: 99%