Abstract

SO.11.04

Corneal diseases in children – pathogenesis and therapeutic strategies

Tina Dietrich, Agnes B. Renner, Horst Helbig, Isabel Oberacher-Velten
Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg, Regensburg

Objective
Corneal diseases are frequent causes for blindness in childhood. The etiopathological spectrum is different from that in adults. Diagnostic and therapeutic procedures are demanding because of difficult clinical examination and follow-up in children, the risk of amblyopia, and the lack of evidence-based therapeutic guidelines.
Methods
Retrospective analysis of clinical data including visual acuity, amblyopia, clinical outcome, therapy and co-morbidities of children (0-15 years of age) from our department for pediatric ophthalmology. Review of literature concerning epidemiology and therapeutic concepts.
Results
Corneal anomalies, inflammatory and infectious diseases and traumas were frequent causes of corneal diseases in our pediatric patients. Genetically determined corneal pathologies (e.g. megalocornea, MIDAS syndrome, dermoids) as well as dystrophies (e.g. microcystic dystrophy, mucopolysaccharidosis) and secondary disorders caused by buphthalmos or dysgenesis of the anterior segment were associated with a various visual outcome. Penetrating traumas of the cornea and lens often showed a limited visual outcome because of the reduced possibility of viusal rehabilitation and frequent development of amblyopia. Corneal ulcers were seen in the context of inflammatory diseases (e.g. herpetic keratitis, Lyell syndrome, keratoconjunctivitis vernalis), neurotrophic keratopathy (e.g. after traumatic brain injury) or genetically determined syndromes (e.g. Crisponi syndrome).
Conclusions
There is a wide etiological spectrum of corneal diseases in childhood. Genetic, inflammatory and traumatic causes are the most frequent etiologies. Special therapeutic strategies are needed for treatment of corneal diseases in childhood.

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