RESUMO
Posterior scleritis in children is very rare. In contrast to the adult form, pediatric posterior scleritis has not previously been associated with any systemic disorder. We describe a case of an 11-year-old girl who presented with left eye pain and redness and was found to have posterior scleritis on ultrasonography. Her laboratory work-up revealed a highly elevated antistreptolysin O titer; the rest of her serologic and radiologic evaluation was unremarkable. She was diagnosed with presumed poststreptococcal posterior scleritis and improved with a slow taper of oral steroids.
Assuntos
Esclera/diagnóstico por imagem , Esclerite/etiologia , Infecções Estreptocócicas/complicações , Segmento Anterior do Olho/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Feminino , Humanos , Esclerite/diagnóstico , Infecções Estreptocócicas/diagnóstico , Síndrome , Tomografia de Coerência Óptica , UltrassonografiaAssuntos
Citarabina/efeitos adversos , Uveíte Anterior/induzido quimicamente , Adulto , Citarabina/uso terapêutico , Diagnóstico Diferencial , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Uveíte Anterior/diagnósticoAssuntos
Herpesvirus Humano 3 , Hospedeiro Imunocomprometido , Transplante de Rim/imunologia , Síndrome de Necrose Retiniana Aguda/virologia , Aciclovir/análogos & derivados , Aciclovir/uso terapêutico , Adulto , Antivirais/uso terapêutico , Feminino , Humanos , Transplante de Rim/efeitos adversos , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Valaciclovir , Valina/análogos & derivados , Valina/uso terapêuticoRESUMO
PURPOSE: To describe the disease characteristics and visual outcome of pediatric uveitis. DESIGN: Retrospective, longitudinal observation. PARTICIPANTS: Five hundred twenty-seven pediatric uveitis patients from the National Eye Institute, University of Illinois, Chicago, and Oregon Health Sciences University. METHODS: Retrospective chart review. MAIN OUTCOME MEASURES: Demographics, uveitis disease characteristics, complications, treatments, and visual outcomes were determined at baseline and at 1-, 3-, 5-, and 10-year time points. RESULTS: The patient population was 54% female; 62.4% white, 12.5% black, 2.7% Asian, 2.1% multiracial, and 14.61% Hispanic. Median age at diagnosis was 9.4 years. The leading diagnoses were idiopathic uveitis (28.8%), juvenile idiopathic arthritis-associated uveitis (20.9%), and pars planitis (17.1%). Insidious onset (58%) and persistent duration (75.3%) were most common. Anterior uveitis was predominant (44.6%). Complications were frequent, and cystoid macular edema (odds ratio [OR] 2.94; P = 0.006) and hypotony (OR, 4.54; P = 0.026) had the most significant visual impact. Ocular surgery was performed in 18.9% of patients. The prevalence of legal blindness was 9.23% at baseline, 6.52% at 1 year, 3.17% at 3 years, 15.15% at 5 years, and 7.69% at 10 years. Posterior uveitis and panuveitis had more severe vision loss. Hispanic ethnicity was associated with a higher prevalence of infectious uveitis and vision loss at baseline. CONCLUSIONS: The rate and spectrum of vision threatening complications of pediatric uveitis are significant. Prospective studies using standard outcome measures and including diverse populations are needed to identify children most at risk.
Assuntos
Uveíte/epidemiologia , Uveíte/fisiopatologia , Adolescente , Cegueira/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Prevalência , Estudos Retrospectivos , Estados Unidos/epidemiologia , Uveíte/diagnóstico , Uveíte/terapia , Baixa Visão/epidemiologia , Acuidade Visual/fisiologiaRESUMO
Nontuberculous mycobacterial (NTM) infections are becoming an increasingly important complication in ophthalmology, particularly among immunocompromised patients. We report a case of NTM in a 66-year-old male immunosuppressed after cardiac transplantation. Chronic granulomatous iridocyclitis progressed to purulent endophthalmitis despite intraocular and systemic antimicrobial therapy. Direct immunoflourescent staining of the vitrectomy specimen revealed acid-fast bacilli. Biopsies of nodular skin lesions revealed non-caseating granulomas with acid-fast bacilli. Cultures of skin and eye biopsies yielded Mycobacterium haemophilum. Despite aggressive combination antimicrobial therapy, the eye was eventually enucleated. Resolution of systemic infection occurred with the addition of granulocyte macrophage-colony stimulating factor. This is the first reported case of M. haemophilum endophthalmitis.