Systemic microcirculation and vascular impairment biomarkers in children with uveitis

Uveitis is a potentially blinding intraocular inflammation involving uvea and nearby structures as retina and sclera with its vessels. It can have many various infectious and non-infectious causes. After excluding an infectious aetiology or a systemic underlying condition a cause of a significant part of non-infectious uveitis still frequently remains unknown. Uveitis in these cases is being clinically seen as an isolated ocular condition. The severity of it is however frequently requesting aggressive systemic immunomodulatory therapy because local treatment is not sufficient to preserve vision. The fact that these patients frequently have severe retinal vasculitis and/or diffuse vascular leakage, macular oedema, high initial anterior chamber flare and rapidly progressive glaucoma, all compromising the vision, suggest systemic vascular and microcirculatory abnormalities. These systemic abnormalities and impairment in the vascular activation and regeneration in uveitis in children are not known yet. Investigation of microcirculation and potential biomarkers of vascular activation, growth and regeneration in children with uveitis would increase our understanding of the pathophysiology of this challenging vision threatening condition in the great variety of its different clinical forms and provide new potential biomarkers setting step forward towards personalized medicine in paediatric uveitis. This approach has as goal to improve the current diagnostic and therapeutic strategies, give better insight in the prognosis and bring us to a more holistic approach in children with uveitis.

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Carlyn Kouwenberg