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Clinical Characteristics and Therapeutic Outcomes of Pediatric Blepharokeratoconjunctivitis
Jayoon Moon1,2, Junseok Lee1,3, Mee Kum Kim1,2
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Insights
Pediatric blepharokeratoconjunctivitis (BKC) often resolves with treatment, but recurrence is common. Recurrence significantly increases astigmatism, highlighting the need for vigilant monitoring and prompt management in children with BKC.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Corneal diseases
Background:
- Blepharokeratoconjunctivitis (BKC) is an inflammatory eye condition affecting children.
- Understanding its clinical course and outcomes is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics, disease progression, treatment efficacy, and prognostic factors in pediatric patients diagnosed with BKC.
- To identify factors associated with recurrence and visual outcomes.
Main Methods:
- Retrospective review of medical charts for 137 pediatric patients (≤15 years) diagnosed with BKC between 2004 and 2020.
- Data collected included demographics, ocular findings, corneal lesion characteristics, treatment, and outcomes.
Main Results:
- The most frequent corneal lesion was neovascularization (77.4%), followed by infiltration (51.8%) and scarring (43.1%).
- Disease remission was achieved in 95% of patients, with significant visual acuity improvement (P = 0.001).
- Recurrence affected 52.6% of patients, and was positively associated with higher final cylinder power.
Conclusions:
- While 95% of pediatric BKC cases achieved remission, over half experienced recurrence.
- Recurrence was linked to significant astigmatism, emphasizing the importance of ongoing observation.
- Prompt management and monitoring are essential for preserving vision in children with BKC.
Purpose:
The purpose of this study was to determine the clinical characteristics, disease course, therapeutic outcomes, and prognostic factors for pediatric patients with blepharokeratoconjunctivitis (BKC).
Methods:
A retrospective medical chart review was performed for patients aged 15 years or younger who had been diagnosed with BKC between 2004 and 2020 at 2 tertiary hospitals in Korea. The following data were collected: demographics, medical history, ocular findings, geometric profiling of corneal lesion, medical management, and outcomes.
Results:
A total of 137 patients (90 female and 47 male) were included. The patients' mean age was 8.3 ± 3.8 years at disease onset. Both eyes were involved in 57.7% of cases. The most common corneal lesion was corneal neovascularization (77.4%), followed by clinically visible corneal infiltration (51.8%) and stromal scarring (43.1%). Most of the corneal lesions involved a single quadrant, most commonly the inferior quadrant. After treatment, disease remission was achieved in 95% of patients, and visual acuities improved from 0.2 ± 0.3 logarithm of minimal angle of resolution at disease presentation to 0.1 ± 0.3 logarithm of minimal angle of resolution at final follow-up ( P = 0.001). Recurrence occurred in 52.6% of patients. Cylinder power was significantly higher in patients with recurrence than in those without. The number of cases of recurrence was positively associated with final cylinder power.
Conclusions:
Although the treatment induced disease remission in 95% of children with BKC, recurrence occurred in 52.6% of those cases. Because recurrence resulted in significant astigmatism, careful observation for recurrence and prompt management are warranted for preservation of vision in pediatric patients with BKC.
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