RESUMEN
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.
Asunto(s)
Esclerótica/diagnóstico por imagen , Escleritis/etiología , Infecciones Estreptocócicas/complicaciones , Segmento Anterior del Ojo/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Femenino , Humanos , Escleritis/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Síndrome , Tomografía de Coherencia Óptica , UltrasonografíaAsunto(s)
Citarabina/efectos adversos , Uveítis Anterior/inducido químicamente , Adulto , Citarabina/uso terapéutico , Diagnóstico Diferencial , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Leucemia Mieloide Aguda/tratamiento farmacológico , Masculino , Uveítis Anterior/diagnósticoAsunto(s)
Herpesvirus Humano 3 , Huésped Inmunocomprometido , Trasplante de Riñón/inmunología , Síndrome de Necrosis Retiniana Aguda/virología , Aciclovir/análogos & derivados , Aciclovir/uso terapéutico , Adulto , Antivirales/uso terapéutico , Femenino , Humanos , Trasplante de Riñón/efectos adversos , Síndrome de Necrosis Retiniana Aguda/diagnóstico , Síndrome de Necrosis Retiniana Aguda/tratamiento farmacológico , Valaciclovir , Valina/análogos & derivados , Valina/uso terapéuticoRESUMEN
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.
Asunto(s)
Uveítis/epidemiología , Uveítis/fisiopatología , Adolescente , Ceguera/epidemiología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Prevalencia , Estudios Retrospectivos , Estados Unidos/epidemiología , Uveítis/diagnóstico , Uveítis/terapia , Baja Visión/epidemiología , Agudeza Visual/fisiologíaRESUMEN
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.