Anterior Uveitis in a Child Manfred Zierhut Centre of Ophthalmology University of Tuebingen, Germany

Ocular History anterior uveitis known since 2001 since then topical corticosteroids

Ocular History at Presentation 9 year old boy, German origin red eye light sensitive pain slow visual reduction since 2 months

General History scoliosis „noises from the heart“, investigation was normal

First Presentation – Ocular Examination VA: OD: 0,4 / OS: 1,25 IOP: 22 / 14 mmHg OD: small endothelial precipitates AC cells (3+), no posterior synechiae 1+ cells in the anterior vitreous OS: regular

First Presentation - Fundus OD: mild edema of the optic disc macula edema Amsler Grit: OD: metamorphopsia OCT: cystoid macula edema 805 µm. OS: regular

Diagnosis from the transfering Ophthalmologist Panuveitis suggestive for HSV-Infection

Therapy Suggestion from the transfering Ophthalmologist Triamcinolone intravitreally

Our Diagnosis Anterior uveitis with Macula edema

Treatment Decortin H (1 mg/kg bodyweight, 50 mg/d) Acetacolamide (2x 125 mg/day)

Follow up - After 1 Month December 2004: OCT: OD macula dry VA: OD 0,5 IOP 34/22 mmHg

Follow Up – After 2 Months January 2005: VA OD 0,6p IOP 30/22 mmHg hospitalization suggestive for steroid-responder good response to antihypertensive treatment

Conclusion macular edema is a complication of all anatomical types of uveitis and not automatically leading to the name of „panuveitis“ macular edema in HSV-induced anterior uveitis is very rare in steroid-responders intravitreal corticosteroids can be deleterious, esp. in children acetacolamid can be very effective in the treatment of macular edema