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Pediatric Uveitis and Scleritis in a Multi-Ethnic Asian Population
Samanthila Waduthantri1,2, Soon-Phaik Chee1,2,3,4
1Singapore Eye Research Institute, Singapore, Singapore.
Insights
Pediatric uveitis and scleritis are often noninfectious, with posterior scleritis being most common. Delayed presentation and poor initial vision correlate with worse outcomes in children.
Area of Science:
- Ophthalmology
- Pediatric eye diseases
- Inflammatory eye conditions
Background:
- Pediatric uveitis and scleritis are serious ocular inflammatory conditions.
- Understanding their demographics and clinical features is crucial for timely diagnosis and management.
Purpose of the Study:
- To characterize the demographics and clinical presentations of pediatric uveitis and scleritis.
- To identify factors associated with visual outcomes in affected children.
Main Methods:
- Retrospective review of clinical records of pediatric patients diagnosed with uveitis or scleritis.
- Data collected spanned from January 1989 to January 2016 at a tertiary eye care center.
Main Results:
- Seventy-three children were analyzed; 54 had uveitis and 19 had scleritis.
- Noninfectious uveitis was prevalent (37.0%), with posterior uveitis being most common (27.8%). Posterior scleritis predominated (94.7%).
- Delayed presentation and initial visual acuity <0.3 LogMAR were linked to poor visual outcomes (p=0.03 and p=0.007, respectively).
Conclusions:
- Noninfectious causes are the majority etiology for pediatric uveitis and scleritis.
- Juvenile idiopathic arthritis-associated uveitis was infrequently observed.
- Early detection and intervention are vital for improving visual prognosis.
Abstract:
Purpose: To describe the demographics and clinical characteristics of pediatric uveitis and scleritis at a tertiary eye care center.Methods: Clinical records of children with either uveitis or scleritis that presented between January 1989 and January 2016 were reviewed retrospectively.Results: Seventy-three patients were identified. Fifty-four had uveitis and 19 had scleritis. Posterior uveitis was the most common (27.8%), followed by intermediate uveitis (25.9%), panuveitis (25.9%) and anterior uveitis. Majority were noninfectious uveitis (37.0%), and 29.6% were idiopathic. Common associations were sarcoidosis (14.8%), HLA-B27 haplotype (9.3%) and toxoplasmosis (7.4%). Posterior scleritis was more common (94.7%) than anterior scleritis and majority were idiopathic (68.4%). Delayed patient presentation and presenting visual acuity worse than 0.3 LogMAR were associated with poor visual outcome (p = .03; OR = 0.17; 95% CI, 0.03-0.84 and p = .007; OR = 0.09; 95% CI, 0.02-0.52 respectively).Conclusion: Majority had noninfectious etiologies. Uveitis associated with juvenile idiopathic arthritis was rare.
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