Long-term Prognosis of Pediatric Ocular Disease.

Juntendo Iji Zasshi Pub Date : 2024-03-28 eCollection Date: 2024-01-01 DOI:10.14789/jmj.JMJ23-0040-R
Toshiyuki Yokoyama
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Abstract

Several problems differentiate the treatment of children, especially those with congenital ocular disease, from adults, including the absence of complaints and the complication of systemic diseases. However, the most challenging is the continuing developing anatomical and functional development and immaturity in children. Consequently, the timing of disease onset and treatment can greatly affect the prognosis, and the prognosis cannot be confirmed without long-term follow-up periods. The prognosis for unilateral congenital cataract is very poor. However, some cases achieved good vision with successful refractive correction and amblyopia therapy, suggesting that long-term parental enthusiasm and adherence are important for the visual prognosis. Penetrating keratoplasty is rarely performed in children, and outcomes at our hospital have been extremely poor for congenital corneal opacity over the past 28 years. The visual prognosis is also poor for large limbal dermoids approaching the center of the cornea, which did not respond to preoperative amblyopia therapy. Consequently, early excision, lamellar keratoplasty, wearing of hard contact lenses, and amblyopia therapy were considered necessary. Treatment of pediatric ocular disease should consider the pros and cons, methods, and timing, especially the development of the pediatric eye and the time of onset of the disease.

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小儿眼疾的长期预后。
儿童,尤其是患有先天性眼病的儿童,在治疗上有几个与成人不同的问题,包括没有主诉和并发全身性疾病。然而,最具挑战性的是,儿童的解剖和功能发育仍在继续发展,而且尚未成熟。因此,发病和治疗的时机会对预后产生很大影响,而且如果没有长期随访,预后也无法确定。单侧先天性白内障的预后很差。然而,一些病例通过成功的屈光矫正和弱视治疗获得了良好的视力,这表明家长的长期热情和坚持对视力预后非常重要。穿透性角膜成形术很少在儿童中开展,在过去的 28 年中,我院先天性角膜混浊的治疗效果极差。对于接近角膜中心的大型角膜缘皮样囊肿,术前弱视治疗无效,视觉预后也很差。因此,有必要尽早进行切除术、板层角膜移植术、佩戴硬性隐形眼镜和弱视治疗。小儿眼病的治疗应考虑利弊、方法和时机,尤其是小儿眼球的发育和发病时间。
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审稿时长
9 weeks
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