Zusammenfassung
Die Uveitis intermedia betrifft 10 - 20 % aller Kinder, die an einer Uveitis erkranken.
Im Vergleich zur anterioren Uveitis ist eine Zuordnung der zugrunde liegenden Systemerkrankung
komplexer. Neben der häufigen idiopathischen Pars planitis kann die Uveitis intermedia
postinfektiöser oder autoimmunogener Ursache sein. Gerade bei seltenen zugrunde liegenden
systemischen Begleiterkrankungen ist es notwendig, dass an eine Assoziation gedacht
wird und eine gezielte Differenzialdiagnostik eingeleitet wird. Der Artikel informiert
über mögliche Ursachen einer Uveitis intermedia im Kindesalter und vergleicht die
Inzidenz dieser assoziierten Erkrankungen mit dem Vorkommen im Erwachsenenalter.
Abstract
Round 10 - 12 % of all children who present with signs of uveitis suffer from intermediate
uveitis. Compared to uveitis anterior in children, the association of intermediate
uveitis to a systemic disease is much more complicated. Most cases of uveitis intermedia
are idiopathic and show the signs of a pars planitis. Post-infectious and immunological
causes are difficult to detect. In cases of uveitis in children, it is necessary to
know the specific symptoms of possible underlying systemic diseases. On this basis,
an adequate and specific diagnosis will most probably be successful. This paper presents
the different causes of uveitis intermedia in childhood and compares the incidence
of the disease in comparison with adults as far as this is mentioned in the literature..
Schlüsselwörter
Uveitis intermedia - Pars planitis - Autoimmunerkrankungen - postinfektiöse Erkrankungen
Key words
uveitis intermedia - pars planitis - autoimmune diseases - postinfectious diseases
- children
Literatur
- 1
Ayerty H A. et al .
Bilaterale Uveitis intermedia.
Opthalmologe.
2003;
100
1106-1108
- 2
Becker M L, Rose C D.
Blau syndrome and related genetic disorders causing childhood arthritis.
Pediatr Rheumatol.
2005;
7
427-433
- 3
BenEzra D, Cohen E, Maftzir G.
Uveitis in children and adolescens.
Br J Ophthalmol.
2005;
89
444-448
- 4
Beseda E, Frauens B J, Schatz S.
Choroiditis, pigment epithelial detacment and cystoid macular oedema as complication
of post-streptococcal syndrome.
Opom Vis Sci.
2004;
81
578-585
- 5
Bonfioli A A. et al .
Intermediate uveitis.
Sem Ophthalmol.
2005;
20
147-154
- 6
Boyd S R, Young S, Lightmann S.
Immunpathology of the non-infectious posterior and intermedia uveitis.
Surv Ophthalmol.
2001;
45
209-233
- 7
Cooper G S, Stroehla B C.
The epidemiology of autoimmune diseases.
Autoimmunity Reviews.
2003;
2
199-125
- 8
de Boer J, Wulffraat N, Rothova A.
Visual loss in uveitis of childhood.
Br J Opthalmol.
2003;
87
879-884
- 9
de Boer J. et al .
Long-term follow up of intermediate uveitis in children.
Am J Ophthalmol.
2006;
141
616-621
- 10
El-Shabrawi Y. et al .
High levels of interleukin-12 in the aqueous humor and vitreous of patients with uveitis.
Opthalmology.
1998;
105
1659-1663
- 11
Fietta P.
Behcet disease: familiar clustering and immunogenetics.
Clin Exp Rheumatol.
2005;
23
96-105
- 12
Fontain P A. et al .
Antibodies to streptococcal surface enolase react with human alpha-enolase: implication
as post streptococcal sequelae.
J Inf Dis.
2000;
182
1712-1721
- 13
Gallagher M J. et al .
Post-streptococcal uveitis.
Acta Ophthalmol Scand.
2006;
84
424-428
- 14
Giles C L.
Pediatric intermediate uveitis.
J Pediatric Ophthalmol Strabismus.
1989;
26
136-9
- 15
Gordon L.
Fuch’s heterocromic cyclitis: New clues regarding pathogenesis. Editorials.
A J Opthalmol.
2004;
138
133-134
- 16
Guest S, Funkhouser E, Lightmann S.
Pars planitis: a comparison of childhood outset and adult onset diseases.
Clin Exp Ophthalmol.
2001;
29
81-84
- 17
Heinz C, Steuhl K P, Heiligenhaus A.
Uveitis bei Sarkoidose im Kindesalter.
Klin Monatbl Augenheilkd.
2005;
222
348-352
- 18
Heiligenhaus A. et al .
Juvenile idiopathische Arthritis und Uveitis: Sreening und antientzündliche Therapie.
Klin Monatsbl Augenheilkd.
2003;
220
738-753
- 19
Hoffmann A L, Milman N, Byg K E.
Childhood sarcoidosis in denmark 1979 - 1994: incidence, clinical features and laboratory
results at presentation in 48 children.
Acta Paediatr.
2004;
93
30-36
- 20
Huppertz H J, Münchmeier D, Lieb W.
Ocular manifestation in children and adolescents with lyme arthritis.
Br J Ophthalmol.
1999;
83
1149-1152
- 21
Hyams J S. et al .
Development and validation of pediatric Crohn’s disease activity index.
J Pediatr Gastroenterol Nutr.
1991;
12
439-447
- 22
Kadayifcilar S, Eldem B, Tumer B.
Uveitis in childhood.
J Pediatr Opthallmol Strabismus.
2003;
40
335-340
- 23
Khairallah M. et al .
Pattern of childhood-onset uveitis in a referral center in Tunesia, North Africa.
Ocular Imm and Inflam.
2006;
14
225-231
- 24
Kanski J J, Shun-Shin G A.
Systemic uveitis syndromes in childhood: an analysis of 340 cases.
Ophthalmology.
1984;
91
1247-1252
- 25
Knox C M, Wong I G, Love P.
Chronic uveitis following a streptococcal illness.
Can J Ophthalmol.
1999;
34
99-100
- 26
Krause I. et al .
Childhood Behcet’s disease: clinical features and comparison with adult-onset disease.
Rheumatology.
1999;
38
457-462
- 27
La Hey E. et al .
Clinical analysis of Fuchs’ heterocromic cyclitis.
Doc Opthalmol.
1991;
78
225-235
- 28
Mandeville J TH, Levison R D, Holland G N.
The tubolointerstinal nephritis and uveitis syndrome.
Surv Ophthalmol.
2001;
46
195-208
- 29
Michels H.
Die rheumatische Uveitis im Kindesalter.
Mschr Kinderheilkd.
2002;
150
470-476
- 30
Murphy C C. et al .
Systemic CD4 (+) T cell phenotype and activation status in intermediate uveitis.
Br J Ophthalmology.
2004;
88
412-416
- 31
Rosenberg A M.
Uveitis associated with childhood rheumatic diseases.
Curr Opin Rheumatol.
2002;
14
542-547
- 32
Rosenberg K D, Feuer W J, Davis J L.
Ocular complicatins of pediatric uveitis.
Ophthalmology.
2004;
111 (12)
2299-2306
- 33
Rychwalski P J. et al .
Asymptomatic uveitis in young people with inflammatory bowl disease.
J AAPOS.
1997;
1
111-114
- 34
Stanford M R. et al .
Are cytokine gene polymorphismus associated with outcome in patients with idiopathic
intermediate uveitis in the United Kingdom?.
Br J Ophthalmol.
2005;
89
1013-1016
- 35
Steinlin M I. et al .
Eye problems in children with multiple sclerosis.
Pediatr Neurol.
1995;
12
207-212
- 36
Szer I S, Taylor E, Steere A C.
The long-term course of lyme arthritis in children.
N Eng J Med.
1991;
325
159-163
- 37
Tugal-Tutkun I. et al .
Changing pattern in uveitis in childhood.
Ophthalmology.
1996;
103
375-83
- 38
Tugal-Tutkun I, Urgancioglu M.
Childhood-onset in Behcet disease: a descriptive study of 36 cases.
Am J Ophthalmol.
2003;
136
1114-1119
- 39
Weeks C.
Care of pediatric patients with uveitis.
INSIGHT.
2003;
Volume XXVIII, No 3
64-66
- 40
Quentin C D, Reiber H.
Fuchs Heterocrmic Cyclitis: Rubella virus antibodies and genome in aqueous humor.
Am J Ophthalmol.
2004;
138 (1)
46-54
Katrin Engelmann
Augenklinik des Klinikums Chemnitz gGmbH
Flemmingstraße 2/PSF 948
09009 Chemnitz
Telefon: ++49/3 71/33 33 32 30
Fax: ++49/3 71/33 33 33 23
eMail: k.engelmann@skc.de