Lens-induced uveitis in premature twins with congenital cataracts?

Session Details

Session Title: Presented Poster Session: Cataract - Paediatric

Session Date/Time: Monday 07/09/2015 | 09:30-11:00

Paper Time: 09:30

Venue: Poster Village: Pod 1

First Author: : K.Pekovits AUSTRIA

Co Author(s): :    C. Faschinger              

Abstract Details

Purpose:

We herein describe the extremely rare association of congenital cataract with and without granulomatous uveitis in the absence of an infectious agent or a detectable infection in two male premature non-identical twins.

Setting:

Three weeks after birth, the first twin showed a cataract with uveitis in the right eye and a mild cataract on the left eye, which developed a uveitis 2 weeks later. The second twin revealed first a segmental cataract in the left eye and developed uveitis two months later.

Methods:

Common causes of granulomatous uveitis in newborns were excluded by clinical and serological investigations conducted in mother and children. All serological tests in both children, as well as tests of aqueous humor in the one twin and lens material in the other twin, were negative. There was no clinical evidence of a genetic disorder, systemic metabolic disease or inherited syndrome. No ocular anomalies such as developmental anomalies, dystrophies or degenerations of the anterior and posterior segment could be detected.

Results:

In the twins, the cataract appeared first and subsequently the anterior granulomatous uveitis arose. In both cases, conservative treatment with corticosteroids could not repress the sudden appearance of uveitis. Lens aspiration resulted in prompt resolution of the uveitis in both cases. In the absence of any detectable infectious agent and the lack of a genetic disorder, systemic metabolic disease or inherited syndrome, a phacogenic pathomechanism that provoked and further maintained the intraocular inflammatory reaction might be possible. Probably, lens capsule disintegrity might have released some lens protein, which provoked and further maintained an intraocular inflammatory reaction.

Conclusions:

This report should increase awareness that in some rare cases lens extraction is the only way to control intraocular inflammation in presence of both anterior uveitis and cataract. Especially in infants, recognition of lacking improvement of uveitis to conservative treatment should prompt consideration of a cataract surgery without delay to prevent possible amblyopia.

Financial Interest:

NONE