Preumed trematode-induced granulomatou anterior uveiti: a newly recognized caue of intraocular inflammation in children from outh India

PURPOE: To decribe the epidemiologic, clinical, and hitopathologic feature of a preumed trematode granulomatou anterior uveiti, primarily in children from outh India. DEIGN: Propective, noncomparative, cae erie. METHOD: Children with clinical evidence of granulomatou anterior uveiti were elected for the tudy. Thoe who preented with ditinct anterior chamber nodule were evaluated. Demographic detail, uch a clinical finding and coure of illne, were noted. Patient underwent either medical treatment or urgical apiration of the leion baed on the ize of the leion. Apirated material were ubjected to hitopathologic analyi and culture for bacteria and fungi. Repone to treatment and final viual tatu were evaluated. REULT: One hundred thirteen patient with anterior chamber nodule were een between 1998 and 2000. Ninety-three (82.4%) were male and 20 (17.7%) were female. The median age wa 11.0 year. All patient were from outh India and all gave a hitory of bathing or wimming in the local pond or river. All had normal ytemic work up. Of the 113 patient, 110 had anterior chamber nodule and three had both anterior chamber and ubconjunctival nodule. Apirate of the anterior chamber leion revealed lymphocyte, intact and necrotic neutrophil, and eoinophil admixed with hitiocyte. One ubconjunctival nodule howed necrotizing granuloma, diplaying the tegument of a trematode. Thoe patient who were followed had good viual recovery after medical or urgical intervention or both. CONCLUION: The preent tudy how a newly recognized granulomatou anterior uveiti caued by a preumed water-borne trematode infection. Thi infection appear to be a common caue of pediatric granulomatou anterior uveiti in outh India.