DR. SANDHYA SHRESTHA

DR. VINITA GUPTA, DR. VINITA GUPTA, DR. NISHA RANI, Dr. LUTHRA SAURABH

Abstract

In childhood onset uveitis, autoinflammatory & autoimmune conditions more likely present with ocular inflammation. Amongst these JIA is commonest with chronic anterior uveitis reported in 83%,posterior uveitis in1% and optic neuritis in 0.15%. We report a case of a 9 year old male with ANA positive JIA who presented with right eye complicated cataract for which lens aspiration with IOL implantation was done. Despite aggressive use of pre- & post-operative steroids, he developed optic disc oedema with associated mild vitritis at 3 weeks follow up. Detailed evaluation was negative for vasculitis profile, while MRI brain revealed right eye optic nerve head oedema with scleral flattening with normal nerve signal. Patient did not respond to pulse methyl prednisolone therapy leading to diagnostic dilemma of vasculitis and posterior uveitis associated with Behcet’s disease & sarcoidosis. Patient was started on Adalimumab on which there was decreased optic nerve swelling & vitritis at 4 weeks.