Pathogenesis, diagnostics and complications of uveitis in childhood.

Specific knowledge about cause and treatment of uveitis in childhood is for the
present inadequately available in literature since uveitis in childhood is
rare.

First, to develop a diagnostic method for non-infectious uveitis in childhood.
Second, to analyze iris and ciliary body tissues of children with uveitis on
the presents of inflammatory infiltrate. The results of this study will
contribute in the diagnostics of uveitis in childhood and in clarifying the
pathogenesis of uveitis in childhood.
Third, to determine the long-term effect of glaucoma valve (tube) implantation
on corneal endothelial cells in children with uveitis. The results of this
study shall contribute to the better management of secundary glaucoma due to
uveitis by children.

We will analyze the relation between protein profiles in the aqueous humor and
the type of uveitis. Furthermore, tissue fragments of the iris and ciliary body
of children with uveitis, who are operated on for secondary glaucoma, will be
analyzed on the presence of inflammatory infiltrates. The tissue
characteristics will be related to the cause of the intraocular inflammation
and visual prognosis.
As third part of the study we will investigate and evaluate the long-term
effects of glaucoma valve (tube) implantation in children with uveitis. The
endothelial cell density will be prospectively evaluated by making of
endothelialpictures once a year in children with a glaucoma implant and in a
control group children with uveitis without the hystory of an eye opearation.

The treatment and therapy of the patients remains unchanged. Material will only
be collected during a therapeutically necessary glaucoma or cataract surgery.
Aqueous humor and possibly tissue fragments, which otherwise would be lost
during surgery, will be collected. The cataract or glaucoma surgery will remain
unchanged. When the child is under general anesthesia a venous punction (10ml)
under sterile circumstances will be performed. The patient will not notice
anything due to the anesthetics. The endothelial cell density will be measured
once a year during 3 years in children with uveitis and a history of glaucoma
surgery and children with uveitis without the hystory of glaucoma and eye
opearation. Endothelial cell density measurement is painless and non-invasive.
It takes about 5 minutes a time. During the measurement the child sits on a
chair with his/ her chin on the chin-rest and looks at a green point. The
device makes the picture of a corneal endothelial cells. This device does not
make use of light or sound wich could scare a child.