Abstract
Purpose :
Pediatric uveitis is often accompanied by involvement of the ocular vasculature, such as retinal vasculitis or capillary leakage. However, involvement of the extraocular vasculature has not been studied before in this patient group. We hypothesize that there are differences in systemic microcirculation between pediatric uveitis patients and healthy pediatric controls.
Methods :
The systemic microcirculation was investigated through nailfold capillaroscopic (NFC) assessment in 101 children with noninfectious uveitis, 22 children with juvenile idiopathic arthritis (JIA) without uveitis, and 25 healthy pediatric controls. The assessed NFC parameters were: capillary density (number of capillaries per mm), dilated capillaries (apex of >20µm), avascular areas, the presence of microhemorrhages, and capillary morphology (normal, multiple crossings, tortuous, bushy, ramified, non-convex, or bizarre capillaries). The NFC parameters are shown in Figure 1. NFC differences were calculated through regression analysis adjusted for age and sex between: (1) uveitis patients and healthy controls; (2) different subtypes of uveitis and healthy controls; (3) JIA-associated uveitis and JIA without uveitis.
Results :
Pediatric uveitis patients had a lower mean capillary density (7.2 vs. 7.5, Padj=0.041), and a higher number of dilated capillaries, compared to healthy pediatric controls (0.16 vs. 0, Padj=0.048). Multiple crossings and ramified capillaries were also found more frequently, compared to healthy controls (21% vs. 12%, Padj=0.041; 9% vs. 3%, Padj=0.023).
Compared to healthy controls, intermediate uveitis was associated with a higher number of dilated capillaries per mm (0.57 vs. 0, Padj<0.001), whereas anterior uveitis patients had a lower mean capillary density (7.0 vs. 7.5, Padj=0.007), and more multiple crossings (Padj=0.044).
Patients with JIA-associated uveitis had a lower mean capillary density (6.9 vs 7.8, Padj<0.001), and a higher occurrence of microhemorrhages (49% vs. 22%, P=0.020), compared to JIA patients without uveitis. No significant association between NFC parameters and retinal vasculitis or capillary leakage was found.
Conclusions :
The systemic microcirculation seems to be involved in pediatric uveitis with different presentation in anterior and non-anterior uveitis. These alterations in the systemic microcirculation seems to be independent from retinal vasculitis and capillary leakage.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.