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Follow-up Findings of Non-infectious Pediatric Uveitis Patients
Zahide Ekici Tekin1, Gülçin Otar Yener2, Selen Akbulut3
1Ankara Bilkent City Hospital, Children's Hospital, Clinic of Pediatric Rheumatology, Ankara, Turkey.
Insights
Early recognition and prompt systemic treatment are crucial for preserving vision in children with uveitis. This study highlights common causes, treatments, and complications in pediatric uveitis cases.
Area of Science:
- Ophthalmology
- Pediatric Rheumatology
- Immunology
Background:
- Pediatric uveitis is a significant cause of vision impairment in children.
- Understanding the demographic and clinical spectrum is vital for effective management.
Purpose of the Study:
- To describe the demographic and clinical characteristics of pediatric uveitis patients.
- To identify associated rheumatologic diseases and treatment outcomes.
Main Methods:
- Retrospective cross-sectional study of 46 pediatric patients diagnosed with uveitis.
- Data collected included demographics, uveitis characteristics, underlying diseases, treatments, side effects, and complications over a minimum 6-month follow-up.
Main Results:
- Juvenile idiopathic arthritis was the most common associated condition (23.9%).
- Significant visual impairment occurred in 13.2% of eyes, with 1.2% experiencing blindness.
- Posterior synechiae were the most frequent complication (13.2%).
Conclusions:
- Early diagnosis and aggressive systemic treatment, particularly for chronic pediatric uveitis, are essential for visual preservation.
- Prompt intervention can mitigate complications and improve long-term visual outcomes.
Objectives:
In this study, we aimed to describe the demographic and clinical findings of children with uveitis at a tertiary pediatric rheumatology and ophthalmology center.
Materials And Methods:
A retrospective cross-sectional study was conducted with 46 patients who were diagnosed with uveitis before the age of 16 years and were followed regularly for at least 6 months between January 2013 and June 2019. Demographic data, uveitis characteristics, underlying diseases, systemic treatment modalities, drug side effects, complications, and surgical intervention were evaluated.
Results:
Eighty-three eyes of 46 patients were included in the study. The mean age at diagnosis of uveitis was 9.2±4.5 (1.6-15.6) years, and the mean uveitis follow-up period was 54±41 (6-191) months. Twenty-one patients (45.7%) had uveitis associated with rheumatologic diseases. Juvenile idiopathic arthritis was the most common disease (23.9%). Visual acuity was categorized as moderately impaired in 6 eyes (7.2%), severely impaired in 4 eyes (4.8%), and blindness in 1 eye (1.2%). Methotrexate (87%) was the most frequently used systemic immunosuppressive agent in treatment. Adalimumab (73.9%) was added to treatment in resistant cases. Thirty-five patients (76.1%) had complications in at least 1 eye secondary to uveitis or uveitis treatment. Posterior synechiae (11 eyes, 13.2%) was the most common complication during treatment.
Conclusion:
In order to preserve visual acuity, pediatric uveitis should be recognized early and especially persistent/chronic cases should be started on effective systemic treatment immediately.
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