Pediatric uveitis beyond JIA: A vastitude of studied aspects on microcirculation, biomarkers, clinical course and treatment

Abstract

Childhood uveitis represents a rare group of ocular inflammatory entities with a varied spectrum of clinical presentation and treatment. Physicians face several challenges in the management of this potentially sight-threatening disease. Research into pediatric uveitis has mainly focused on uveitis associated with juvenile arthritis, leaving the other types less understood. In this thesis, we aimed to improve the current diagnostic and therapeutic strategies for pediatric uveitis in general. We found that children with idiopathic chronic anterior uveitis had more ocular complications compared to children with uveitis associated with juvenile arthritis. Also, younger age increases the risk for ocular complications in this patient group. Furthermore, we proposed additional diagnostics and investigated the efficacy and safety of novel treatment in pediatric uveitis patients. We also found changes in certain blood proteins with key functions in the coagulation and complement cascade in children with eye inflammation affecting the retina’s blood vessels, suggesting that the microcirculation might play a role. Additionally, we found abnormalities in the blood vessels in the fingers (nailfold capillaroscopy), indicating involvement of the systemic microcirculation in pediatric uveitis. This finding supports our believe that pediatric uveitis might be a manifestation of a disease affecting not only the eye but the systemic immune system and microcirculation. Moreover, it highlights the importance of a multidisciplinary approach in the management of pediatric uveitis patients to provide the best possible care. These new insights may serve as a foundation for more personalized interventions and aid in the development of new approaches for treatment.