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High-dose intravenous methylprednisolone in juvenile non-infectious uveitis: A retrospective analysis.
Clinical Immunology ( IF 8.6 ) Pub Date : 2019-12-18 , DOI: 10.1016/j.clim.2019.108327
Anja Schnabel 1 , Elisabeth Unger 1 , Normi Brück 1 , Reinhard Berner 1 , Ursula Range 2 , Annette Holl-Wieden 3 , Henner Morbach 3 , Anna Leszczynska 4 , Viktoria Bau 4 , Christian M Hedrich 5
Affiliation  

Non-infectious uveitis is associated with visual impairment and blindness. Non-biologic treatment for non-infectious uveitis is not based on strong evidence. A retrospective chart review was conducted to investigate treatment response to high-dose intravenous methylprednisolone (IVMP) in children with non-infectious uveitis. Fifty-six patients (93 eyes affected) were included. In 29% uveitis was associated with juvenile idiopathic arthritis. Uveitis predominately affected the anterior segment, was bilateral and recurrent. Complications were common and included visual loss, synechiae, cataract and/or retinal lesions. Patients received up to 5 IVMP at monthly intervals. Visual acuity improved at 3 and 6 months. Anterior chamber cells, synechiae, keratic precipitates, papillary and/or macular edema improved at 3 months. Children treated with ≥3 IVMP (vs 1 IVMP) experienced trends towards fewer relapses, fewer cataracts and less frequently required treatment with biologic agents. High-dose IVMP induce rapid improvement in children with non-infectious uveitis. Prospective randomized trials are required to confirm results.

中文翻译:

少年非感染性葡萄膜炎大剂量静脉注射甲基强的松龙:回顾性分析。

非感染性葡萄膜炎与视力障碍和失明有关。非感染性葡萄膜炎的非生物治疗不是基于有力的证据。进行回顾性图表审查,以调查非感染性葡萄膜炎患儿对大剂量静脉注射甲基强的松龙(IVMP)的治疗反应。包括五十六名患者(受影响的93眼)。29%的葡萄膜炎与青少年特发性关节炎有关。葡萄膜炎主要影响前节,双侧和复发。并发症很常见,包括视力减退,粘连,白内障和/或视网膜病变。患者每月间隔接受多达5次IVMP。3个月和6个月时视力有所改善。3个月时前房细胞,粘膜,角膜沉淀,乳头状和/或黄斑水肿得到改善。接受≥3IVMP治疗的儿童(vs 1 IVMP)经历了复发的趋势减少,白内障减少以及使用生物制剂治疗的频率降低的趋势。大剂量IVMP可以使非感染性葡萄膜炎患儿的病情得到快速改善。需要前瞻性随机试验以确认结果。
更新日期:2019-12-19
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