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Patterns of childhood-onset uveitis in a referral center in Turkey
Pinar C Ozdal1, Emine Sen, Alper Yazici
1Ulucanlar Eye Hospital, Ankara, Turkey, pinarozdal@hotmail.com.
Insights
Childhood-onset uveitis affects young patients, with nearly 22.3% experiencing visual loss. Behcet's disease is a significant cause of vision impairment in these cases, especially in endemic regions.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Background:
- Childhood-onset uveitis (COU) is a significant cause of pediatric visual impairment.
- Understanding the epidemiology and outcomes of COU is crucial for early intervention and management.
Purpose of the Study:
- To determine the frequency and characteristics of COU.
- To evaluate the rate and specific causes of visual loss in children with uveitis.
Main Methods:
- Retrospective analysis of 121 patients (179 eyes) with uveitis onset before age 16.
- Data collected included age at onset, sex, laterality, systemic diseases, treatments, surgeries, and visual acuity outcomes.
Main Results:
- COU represented 9.6% of all uveitis cases, with a mean onset age of 11.7 years.
- Pars planitis (24%) was the most common type, followed by idiopathic uveitis (16.5%).
- Behcet's disease (16.5%) was the most frequent associated systemic condition, and optic atrophy was the leading cause of severe visual loss (43.7%).
Conclusions:
- Childhood-onset uveitis can lead to significant visual impairment, affecting up to 22.3% of patients.
- Behcet's disease is a major contributor to visual loss in COU, particularly in regions where it is endemic.
Purpose:
This study aimed to investigate the frequency and characteristics of childhood-onset uveitis and evaluate the rate and specific causes of visual loss in this population.
Methods:
The data of 121 patients (179 eyes) with uveitis starting before ≤16 years and followed up for at least 6 months were retrospectively evaluated. Age at onset, sex, laterality, associated systemic disease, laboratory data, therapeutic strategies, surgeries, final visual acuity, and causes leading to visual acuity ≤20/200 were analyzed.
Results:
Childhood-onset uveitis made up 9.6% of our uveitis patients. The mean age at onset was 11.7 years (1-16) and the mean follow-up period was 38.5 months (6-148). Forty-three patients (35.5%) were female and 78 were male (64.5%). The disease was bilateral in 58 (47.9%) and unilateral in 63 (52.1%) patients. Uveitis was mostly (59.5%) seen between 12 and 16 years of age. Pars planitis, observed in 29 (24%) patients, was the leading cause of childhood-onset uveitis. Uveitis was idiopathic in 20 (16.5%) of patients. The most frequently associated diseases were Behcet's disease (BD) in 20 (16.5%), toxoplasmosis in 16 (13.2%), and juvenile idiopathic arthritis (JIA) in 8 (6.6%) patients. Anterior uveitis was observed in 38 (31.4%), intermediate uveitis in 31 (25.6%), posterior uveitis in 30 (24.8%), and panuveitis in 22 (18.2%) patients. The final visual acuity was ≤20/200 in 32/179 eyes (17.9%) of 27/121 patients (22.3%). The most often ocular complication leading to visual acuity ≤20/200 was optic atrophy and had been observed in 14 of 32 eyes (43.7%). Macular scar observed in five eyes (15.6%) was the second most often complication. Etiological distribution of 27 patients with visual acuity ≤20/200 was as follows: 12 had BD (44.4%), 5 had idiopathic uveitis (18.5%), 4 had pars planitis (14.8%), 3 had toxoplasmosis (11.1%), 2 had JIA (7.4%), and 1 had toxocara (3.7%).
Conclusions:
Although rare, childhood-onset uveitis has a blinding potential and causes visual loss in up to 22.3% of the patients. In endemic areas like Turkey, BD may be the most common uveitis-associated systemic disease and the leading cause of visual loss in childhood uveitis as adulthood.
