In panuveitis, inflammation is diffuse without a predominant site. Inflammation is observed in the anterior chamber, vitreous, and choroid.
Sarcoidosis may present in 2 distinct forms in children. In young patients (<5 years), lung disease is rare, and sarcoidosis is more often characterized by the triad of uveitis, granulomatous arthritis, and rash. Early-onset sarcoidosis is considered a pediatric granulomatous arthritis and is phenotypically and genetically similar to familial juvenile systemic granulomatosis (discussed in the following section). Older children (8–15 years) with sarcoidosis have the pulmonary abnormalities and lymph node findings more commonly associated with the adult form of the disease and are also at risk for uveitis. Although anterior uveitis (Fig 24-4) is the most common manifestation of ocular sarcoidosis in children, this disease can produce a panuveitis.
Figure 24-4 Keratic precipitates in sarcoidosis.
(Courtesy of Ken K. Nischal, MD.)
Diagnosis and treatment in children is similar to that in adults (see BCSC Section 9, Uveitis and Ocular Inflammation). However, serum angiotensin-converting enzyme levels, which may be abnormally elevated in patients with sarcoidosis, are normally higher in healthy children than in adults and thus can be misleading in diagnosis of this disease.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.