Involvement of the systemic microcirculation in childhood uveitis
Purpose
To investigate the systemic microcirculation through nailfold capillaroscopic (NFC) assessment in patients with pediatric uveitis.
Methods
In total, 119 children with noninfectious uveitis and 25 healthy pediatric controls were included. The assessed NFC parameters were: capillary density (number of capillaries/mm), dilated capillaries (apex of >20µm), avascular areas, presence of microhemorrhages, and capillary morphology. NFC differences were calculated through regression analysis adjusted for age and sex between uveitis patients and pediatric controls.
Results
Patients with pediatric uveitis had an increased median number of dilated capillaries/mm (0.2 vs. 0, Padj=0.04), and a higher occurrence of ramified capillaries compared to pediatric controls (70% vs. 40%, Padj=0.03). Intermediate uveitis was specifically associated with a higher number of dilated capillaries (0.5 vs. 0, Padj <0.001), whereas anterior uveitis patients had a lower capillary density (7.0 vs. 7.5, Padj=0.008), and more ramified capillaries (1.8 % vs. 0.6%, Padj=0.01) compared to pediatric controls. No significant association was found between NFC parameters and posterior segment vascular inflammatory involvement on fluorescein angiography. The prospective NFC assessment of 20 children with pediatric uveitis did not show a change during 12 months of follow-up.
Conclusion
The systemic microcirculation seems to be involved in pediatric uveitis with different presentation in anterior and nonanterior uveitis. These alterations in the systemic microcirculation seems to be independent from posterior segment vascular inflammatory involvement and do not change over a short period of time.
Conflict of interest
No
Authors 1
Last name
KOUWENBERG
Initials of first name(s)
CV
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 2
Last name
Spierings
Initials of first name(s)
J
Department
Rheumatology & Clinical Immunology
City
Utrecht
Country
Netherlands
Authors 3
Last name
de Groot
Initials of first name(s)
EL
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 4
Last name
de Boer
Initials of first name(s)
JH
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 5
Last name
Kalinina Ayuso
Initials of first name(s)
V
Department
Ophthalmology
City
Utrecht
Country
Netherlands
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