PDF(Pubmed)
Abstract：
Coronavirus disease 2019 (COVID-19) can manifest with ocular symptoms. These symptoms can be divided into isolated events attributed to COVID-19, and those occurring in multisystem inflammatory syndrome in children (MIS-C), a newly diagnosed disease entity associated with COVID-19 infection. Currently, the literature lacks specific guidelines and treatment regimens for COVID-19 ocular symptoms, especially in children. The authors present the case of a 14-and-a-half-year-old boy with bilateral uveitis of the anterior and posterior segments along with vasculitis and optic neuritis associated with SARS-CoV-2 infection. The authors also perform an up-to-date review of all available publications on the treatment of post-COVID-19 uveitis in children described in the literature between 2020 and 2023. In the case described by the authors, the treatment involved a Depo-Medrol 40 mg/mL injection uder the Tenon capsule, with two subconjunctival injections of epinephrine, topical steroid therapy and non-steroidal anti-inflammatory drugs: dexamethasone 0.1%; diclofenac eye drops. In addition, acetylsalicylic acid (150 mg) and pentoxifylline (100 mg, orally) were administered throughout the course of the disease as well as up to 12 months after its termination, until a complete improvement in visual acuity and the withdrawal of ocular lesions were achieved. It can be assumed that this type of treatment is far more beneficial for pediatric patients, with an effect comparable to systemic steroid administration with a preserved improvement in retinal-vascular circulation, without exposing the child to systemic post-steroid complications.
摘要：
2019年冠状病毒病（COVID-19）可表现为眼部症状。这些症状可分为由COVID-19引起的孤立事件，以及儿童多系统炎症综合征（MIS-C）中发生的事件，与COVID-19感染相关的新诊断疾病实体。目前,文献缺乏针对COVID-19眼部症状的具体指南和治疗方案，尤其是儿童。作者介绍了一个14岁半的男孩，患有前后段的双侧葡萄膜炎以及与SARS-CoV-2感染相关的血管炎和视神经炎。作者还对2020年至2023年文献中描述的儿童COVID-19葡萄膜炎治疗的所有可用出版物进行了最新审查。在作者描述的案例中，治疗涉及Depo-Medrol40mg/mL注射Tenon胶囊，结膜下注射了两次肾上腺素，局部类固醇治疗和非甾体抗炎药：地塞米松0.1％;双氯芬酸滴眼液。此外,乙酰水杨酸（150毫克）和己酮可可碱（100毫克，口服）在整个疾病过程中以及终止后的12个月内给药，直到视力完全改善和眼部病变消失。可以假设这种类型的治疗对儿科患者更有益，具有与全身性类固醇给药相当的效果，并保留了视网膜-血管循环的改善，不会使孩子暴露于全身性类固醇后并发症。
