Severe Global Inflammatory Involvement of Ocular Segments and Optic Disc Swelling in a 12-Year-Old Girl with Kawasaki Disease

Abstract

Inflammation of both anterior and posterior segments does not seem to respond to KD-specific treatment and could justify a specific ophthalmologic therapeutic approach.

Blindness and ocular posterior segment involvement in the acute phase of Kawasaki disease: a mini-review

“…The studies reviewed here described five patients with ocular posterior segment involvement in the acute phase of Kawasaki disease (Table 2) [3,[5][6][7][8]. All of these patients were older children in terms of age of disease onset.…”

“…Patient 3, who presented with severe global inflammatory involvement of ocular segments and optic disc swelling, received rescue therapy using 1 mg/kg/day of oral prednisone [6]. Ocular complications resolved after IVIG therapy and aspirin administration in two patients (patients 4 and 6).…”

“…Ocular involvement in this disease is characterized by non-exudative conjunctivitis and anterior uveitis [2]. Posterior segment involvement is rare; however, recent studies have shown the involvement of the ocular posterior segment in the acute phase of Kawasaki disease [3,[5][6][7][8]. This study has reviewed six recent reports of patients associated with blindness and/or ocular posterior segment involvement in the acute phase of Kawasaki disease [3][4][5][6][7][8].…”

Macular oedema in Kawasaki syndrome

“…Given that many middlesized arteries throughout the body are simultaneously implicated in the pathogenesis of KS [1], the routine application of OCT could afford a sensitive and noninvasive means of detecting macular oedema and retinovascular involvement in severely affected children, without subjecting them to further light stress. Since the retinal abnormalities may not necessarily respond to high doses of aspirin and intravenous immunoglobulin, which constitute the established course of treatment for KS [4], adjunctive therapy with corticosteroids may be needed to tackle the posteriorsegment affection and to avert permanent visual loss due to vascular occlusion in this region [5].…”

“…While anterior segment involvement represents a typical diagnostic feature in KS, changes within the posterior segment -mainly papilloedema -have been only seldom documented [3,4]. Since posterior segment involvement is probably not a rare occurrence in KS, the scarcity of reported findings might reflect difficulties in examining the retinae of these impaired and extremely light-sensitive patients rather than an absence of pathological changes per se.…”