Clinical and Imaging Characteristics of Posterior Scleritis in Children.

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Ocular Immunology and Inflammation Pub Date : 2025-01-23 DOI:10.1080/09273948.2025.2455963
Ayala Katzir, Radgonde Amer
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引用次数: 0

Abstract

Background: Posterior scleritis (PS) is a rare phenotype of scleritis. Comprehensive epidemiological studies on PS in children are limited. We aimed to report on its clinical and imaging features in one of the largest pediatric series to date.

Methods: Retrospective review of medical files.

Results: Included were 12 children (7 girls, mean±SD age at diagnosis 13.75 ± 3.3 years,18 eyes, mean follow-up ±SD of 46.7 ± 45.9 months). All patients presented with eye pain followed by headache. Papillitis was the most common presenting sign (16 eyes, 88.9%). Seven patients (58%) showed laboratory markers of systemic inflammation. One patient had periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA). In 2 other patients, Behҫet disease and inflammatory bowel disease were diagnosed subsequently. Initial echography showed increased posterior scleral thickness (mean±SD 2.9 ± 0.68 mm) with a significant reduction four ± 2 months later (mean±SD 1.85 ± 0.62 mm). Retinal nerve fiber layer (RNFL) was thickened in all examined eyes (mean±SD 136.2 ± 28.4 µm) at presentation and it significantly decreased with treatment (109.8 ± 8.2 µm two months later). In 5 patients (42%), diagnosing PS was prompted by Brain imaging. PS was part of orbital inflammatory syndrome in 4 patients (33.3%). All patients were treated with systemic steroids and 91% required steroid-sparing agent. Adalimumab was added in 2 patients. A chronic course was observed in 63.6%. Remission was achieved in 4 patients. Mean±SD presenting LogMAR VA was 0.23 ± 0.3 with marked improvement to 0.04 ± 0.07 one month later.

Conclusion: Searching for an associated autoinflammatory/autoimmune disease is an important step in patients' triaging. B-scan ultrasound remains the gold standard test. OCT proved to be of practical importance in delineating the magnitude of RNFL thickness and could serve as a potential imaging biomarker of disease activity.

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来源期刊
CiteScore
6.20
自引率
15.20%
发文量
285
审稿时长
6-12 weeks
期刊介绍: Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.
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