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Abstract：
Juvenile idiopathic arthritis-associated uveitis is rare in the Japanese population. In this article, we report a child whose macular edema was controlled for years after cataract surgery with adalimumab, and reviewed 26 Japanese patients in the literature. In this case report, a 4-year-old boy developed band keratopathy, posterior iris synechiae, and complicated cataract in both eyes. Oral prednisolone prescribed at another hospital was discontinued due to high intraocular pressure in both eyes as a steroid responder. At the age of 5 years, he started oral methotrexate 8 mg weekly for recurrent bilateral iridocyclitis and then underwent lensectomy with core vitrectomy in both eyes. Planned intraocular lens implantation was cancelled at surgery because the anterior vitreous had severe inflammatory opacity with diffuse retinal edema in both eyes. Due to persistent macular edema in both eyes 5 months postoperatively, at the age of 6 years, he began to use adalimumab injection 20 mg every 2 weeks. The macular structure depicted by optical coherence tomography became normal in 2 months. At final visit at the age of 11 years, he had the best-corrected visual acuity of 0.8 in the right eye and 0.4 in the left eye, with adalimumab 40 mg every 2 weeks and methotrexate 8 mg weekly. In conclusion, macular edema persistent despite oral methotrexate after cataract surgery could be controlled for long term by adalimumab in a child with juvenile idiopathic arthritis. In the Japanese literature, only 26 additional cases with juvenile idiopathic arthritis-associated uveitis have been reported so far.
摘要：
幼年特发性关节炎相关葡萄膜炎在日本人群中很少见。在这篇文章中,我们报告了一名儿童，他的黄斑水肿在接受阿达木单抗白内障手术后被控制了数年，并回顾了26例日本患者的文献。在这个案例报告中,一个4岁的男孩患上了带状角膜病,虹膜后粘连，和双眼复杂的白内障。由于两只眼睛的高眼压作为类固醇反应者，在另一家医院开出的口服泼尼松龙被停用。在5岁的时候，他开始每周口服甲氨蝶呤8mg治疗复发性双侧虹膜睫状体炎,然后在双眼接受晶状体切除术和核心玻璃体切除术.手术时取消了计划的人工晶状体植入，因为前玻璃体具有严重的炎性混浊，双眼均具有弥漫性视网膜水肿。由于术后5个月双眼持续性黄斑水肿，在6岁的时候，他开始每2周使用阿达木单抗注射液20mg.光学相干断层扫描显示的黄斑结构在2个月内恢复正常。在11岁的最后一次访问中，他的右眼最佳矫正视力为0.8，左眼为0.4，阿达木单抗每2周40mg和甲氨蝶呤每周8mg。总之,1例幼年特发性关节炎患儿,阿达木单抗可长期控制白内障手术后尽管口服甲氨蝶呤仍持续的黄斑水肿.在日本文学中,迄今仅报告了另外26例幼年特发性关节炎相关性葡萄膜炎.
