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Patterns of Intermediate Uveitis in Children Presenting at a Tertiary Eye Care Center in South India
Radha Annamalai1, Jyotirmay Biswas2
1Deparment of Uveitis and Ocular Inflammation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Insights
Pediatric intermediate uveitis often shows a self-limiting course over years, with good visual recovery in most children. Despite ocular complications like cataracts, vision loss is limited in this cohort.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Immunology
Background:
- Intermediate uveitis is a significant cause of vision impairment in children.
- Understanding its patterns in pediatric populations is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of intermediate uveitis in children.
- To identify factors associated with visual prognosis in pediatric intermediate uveitis.
Main Methods:
- A retrospective study of 20 consecutive pediatric patients (<16 years) with intermediate uveitis.
- Assessment of demographics, etiology, clinical course, complications, treatment, and visual outcomes.
Main Results:
- Bilateral involvement occurred in 80% of cases.
- Tuberculosis was the most common identified etiology (9 patients).
- Cataract (40%) was the most frequent complication; visual recovery was good in most patients.
Conclusions:
- Childhood intermediate uveitis may have a self-limiting course.
- While complications are common, visual outcomes are generally favorable with appropriate management.
- Early diagnosis and treatment are essential for preserving vision.
Purpose:
To study the patterns of intermediate uveitis in the pediatric age group in a referral eye care center in South India.
Methods:
This is a study of twenty consecutive patients under 16 years of age with intermediate uveitis, conducted at a tertiary referral center. Numerous variables were assessed, including age and gender distribution, laboratory data, the presence of systemic diseases, onset and course of ocular inflammation, clinical features, their complications, therapeutic strategies with their outcomes, remission, final visual acuity (VA), and characteristics associated with poor visual outcome.
Results:
Bilateral involvement was observed in 80% of the patients. Remission was observed in five out of 7 patients (78%) with completed follow-up of 5 years. Final VA improved by at least two lines in 11 patients, remained stable in 6 patients, and worsened in 3 patients. The etiological diagnosis showed one patient with Bechet's disease, one with juvenile idiopathic arthritis, 1 with human leukocyte antigen B27 associated uveitis, 9 with laboratory proven tuberculosis, and 3 with sarcoidosis and 5 where it was idiopathic. The mean follow-up was 4.8 years (range 3-8 years). Cataract was the most frequent complication observed (40%). Glaucoma, choroidal neovascularization, and amblyopia accounted for worsening of vision in three patients.
Conclusion:
Median time of development of complications is about 3 years based on our study. Intermediate uveitis of childhood might exhibit a self-limiting course after several years. Visual recovery is good in the majority, and visual loss is limited despite the high rate of ocular complications.
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