Characteristics of Childhood Presumed Trematode-Induced Granulomatous Anterior Uveitis Using Ultrasound Biomicroscopy

Demographic and Clinical Profile of Pediatric Uveitis in Delta Region, Egypt

PURPOSE

Pediatric uveitis poses unique challenges, characterized by difficulties in performing comprehensive examinations, potential delays in diagnosis, and a heightened risk of ocular complications. This study evaluate the etiologic and clinical characteristics of uveitis in children presenting to the Mansoura Ophthalmic Center, Mansoura, Egypt.

METHODS

A cross-sectional observational study was undertaken involving children diagnosed with uveitis attending the uveitis outpatient clinic at Mansoura University Ophthalmic Center. Comprehensive clinical evaluations were carried out, including detailed history taking and exhaustive ophthalmological examinations. Whenever deemed necessary, Spectral Domain Optical Coherence Tomography (OCT) and Fluorescein Fundus Angiography (FFA) were utilized to secure retinal images. An extensive systemic evaluation was also conducted to discern the diverse causes of uveitis among the participants.

RESULTS

The cohort comprised 63 children, impacting 97 eyes. Bilateral involvement was seen in 54% of cases, with a male predominance of 58.7%. The predominant etiologies of uveitis were presumed trematode-induced (36.7%), Juvenile Idiopathic Arthritis (JIA) accounting for 28.6%, and in 12.7% of cases, the cause remained undetermined. Anterior uveitis emerged as the primary presentation in 79.4% of cases. Regarding visual loss, cataract was the leading cause at 56.4%, followed by vitritis at 38.4%, and macular edema at 20.5%.

CONCLUSION

Anterior uveitis was the most frequent presentation in our pediatric cohort. Despite the challenges, the majority of children with uveitis exhibited no significant visual impairment, with most causes of visual loss being reversible.

Posterior Segment Involvement in Childhood Presumed Trematode Induced Granulomatous Anterior Uveitis

PURPOSE

To outline posterior segment characteristics of presumed-trematode induced granulomatous uveitis.

DESIGN

A cross-sectional case series.

METHODS

The study included 56 patients (60 eyes) presented with anterior chamber (AC) granulomas. Involvement of the posterior segment structures has been documented and reported.

RESULTS

The mean age of the patients was 11.8 years (range 6-14 years). Posterior segment findings were vitritis in 9 eyes (15%), optic disc granuloma in 2 eyes (3.3%), optic disc hyperaemia in one eye (1.7%), macular oedema in 2 eyes (3.3%), epiretinal membrane in 3 eyes (5%), retinal vasculitis in one eye, a peripheral focus of retinitis in one eye (1.7%), and choroid thickening in 10 eyes (6.7%), with localised choroidal granuloma in one eye (1.7%).

CONCLUSION

Presumed trematode-induced anterior chamber (AC) granuloma is not only restricted to the anterior segment of the eye, but posterior segment associations that may threaten vision should also be considered.