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- Title
Management of presumed trematode induced granulomatous uveitis in pediatric patients.
- Authors
Amin, Rowayda Mohamed; Radwan, Alaa E.; Goweida, Mohamed B.; El Goweini, Hesham F.; Bedda, Ahmed M.; Lotfy, Wael M.; Ahmed, Ahmed R. H.
- Abstract
Purpose: To outline the management of newly identified trematode induced uveitis in pediatric patientsStudy design: Prospective interventional case seriesMethods: Patients with distinctive uveitis were recruited to either receive steroid monotherapy or undergo surgical excision of the inflammatory lesions based on a scoring system. Outcome measures included best corrected visual acuity (BCVA), intraocular inflammatory activity, and incidence of ophthalmic complicationsResults: 170 patients (174 eyes) were recruited. Mean age was 11.1 years. Mean initial decimal BCVA (± SD) was 0.58 (± 0.31). Of 116 eyes with disease scores <5, 109 were treated effectively with steroids (93.97%). Surgical excision was offered to 58 patients and proved curative in the treated eyes. Protracted inflammation with persistence of the granulomas was noted in 5 patients refusing surgery. Mean follow up period was 21.5 months. Mean final BCVA was 0.69 (±0.27). A significant change in BCVA was noted (p=0.002). There has not been a need for retreatment in any of the study patients, who were also given instructions on evading exposure to fresh water habitats. Larger lesions, mixed disease morphology, older age at presentation were associated with higher rates of ophthalmic complications and vision lossConclusion: A novel waterborne trematode inducing uveitis has been identified in Egypt. A favorable response to steroid monotherapy is demonstrated in low grade disease, while surgical excision was found to be curative in patients with larger lesions or those showing suboptimal response to medical treatment
- Subjects
EGYPT; UVEITIS; EYE diseases; THERAPEUTICS; VISUAL acuity; FRESH water
- Publication
Japanese Journal of Ophthalmology, 2019, Vol 63, Issue 1, p119
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-018-0632-3