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G. Cunniffe, R. Syed, C. Edelsten; Clinical Significance of Streptococcal Antibodies in Paediatric Uveitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5061.
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Purpose: Streptoccal infection has been proposed as a cause of uveitis, mostly in children where these infections are common but uveitis is rare.There is no epidemiological evidence of an association other than case reports. We examined the clinical and laboratory associations of streptococcal antibodies in new cases of paediatric uveitis to determine if raised levels were associated with a specific pattern of uveitis or lab abnormalities. Methods: Retrospective review of 38 new cases of paediatric uveitis mean onset 7 years [1–16], age at testing 9 years [1–16]. Age–corrected ASO and anti–DNAse antibody levels were compared to type of uveitis [laterality, site, acute,disc oedema] outcome severity [systemic treatment, visual loss, cataract], demographic data and lab abnormalities. Results: Antibody titres were not associated with the presence of any clinical sign or measure of outcome severity. Anti–DNAase titres were higher in patients subsequently found to have a diagnosis other than idiopathic uveitis, [1106u vs 364u, p==0.0043, Mann–Whitney].The peak of titres of both antibodies was between 4 and 6 years of age. Anti–DNAase levels were significantly related to earlier age at testing [p=0.017];88% of those tested before 7 were positive compared to 23% of those tested between 8 and 16 years.There was no relatioon with antinuclear antibodies, sACE or CRP. Conclusions:Younger children with uveitis have a high rate of raised antibodies to streptococci compared to the age–matched normal population. The lack of any association with clinical or laboratory variables and their increased frequency in patients with alternative diagnoses suggest raised streptococcal antibody titres provide little evidence for a post–strep uveitis syndrome.
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