Related Experiment Videos
[Eye complications in 458 children with rheumatoid arthritis]
D E Möller1, A Urban, H E Kraft
1Augenklinik, Klinikum Buch, Berlin.
Insights
Pediatric uveitis, a complication of juvenile rheumatoid arthritis, presents differently than in adults and can lead to severe vision loss, including cataracts. Regular ophthalmologic exams are crucial for early detection and management in children.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Context:
- Juvenile rheumatoid arthritis (JRA) can manifest with endogenous inflammation, primarily uveitis.
- Pediatric uveitis exhibits distinct characteristics compared to adult-onset uveitis.
- Understanding these differences is vital for effective management of JRA in children.
Purpose:
- To analyze the differences and incidences of uveitis in children with rheumatic diseases.
- To compare pediatric uveitis characteristics with those observed in adults.
- To highlight the importance of ophthalmologic surveillance in pediatric rheumatology.
Summary:
- A retrospective analysis of 458 pediatric rheumatology patients revealed that 9.8% experienced uveitis.
- Common complications included lens clouding and cataracts (8 of 9 affected patients), necessitating surgery in some cases.
- Other complications observed were synechiae, band keratopathy, secondary glaucoma, and retinal diseases.
Impact:
- Pediatric uveitis poses a significant threat to vision and overall child development.
- The subtle onset and communication challenges in children necessitate regular ophthalmologic examinations.
- Prompt pediatric-rheumatologic diagnostics are essential for all cases of childhood uveitis.
Background:
Besides arthritis or other systemic manifestations, endogenous inflammation (most commonly uveitis) can be a symptom of rheumatoid arthritis in children. The uveitis of children shows certain differences compared to that in adults. This study will show these differences and their incidences.
Patients And Methods:
Retrospective analysis of the histories of 458 children that were admitted to the pediatric clinic due to rheumatism related diseases. An analysis of the general and pediatric data, laboratory results and therapy were combined with the ophthalmologic data.
Results:
45 (9.8%) of the 458 patients suffered from uveitis at least once during the studied time period between 1992 and 1996. Most common complications of the therapy were clouding of the lens up to full cataract (in both eyes in eight out of nine patients). Seven patients underwent cataract operation. Further complications are synechiae, band shaped keratopathy, secondary glaucoma and retinal diseases.
Conclusion:
Since the pediatric uveitis usually does not take an acute course and since children rarely can articulate themselves precisely, a regular ophthalmologic examination of pediatric rheumatology patients is necessary, as well as every uveitis in children should warrant pediatric-rheumatologic diagnostics. The impact of uveitis is much more severe for children when compared to adults, since it not only endangers the vision but the whole development of the child.