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Visual outcome in pediatric uveitis: A retrospective data review in 277 children
Prasanna Sivakoti1, Meenakshi Swaminathan2, Kowsigan Magesan3
1Resident, Sankara Nethralaya, India.
Insights
Pediatric uveitis in India presents challenges, with over half of affected children experiencing improved vision. However, significant rates of blindness persist, highlighting the need for effective management strategies.
Area of Science:
- Ophthalmology
- Pediatrics
- Immunology
Background:
- Pediatric uveitis is a complex intraocular inflammation affecting children.
- Visual impairment is a significant concern in pediatric uveitis cases.
- Understanding factors influencing visual outcomes is crucial for effective management.
Purpose of the Study:
- To describe visual outcomes in Indian pediatric uveitis patients.
- To identify factors impacting visual prognosis in this population.
Main Methods:
- Retrospective chart review of 277 pediatric uveitis cases (under 18 years).
- Analysis of demographic, anatomical, systemic, and treatment variables.
- Assessment of final visual acuity as the primary outcome measure.
Main Results:
- 51.5% of eyes showed improved visual acuity; 19.7% worsened.
- 19.4% of patients were blind in at least one eye; 5.77% bilaterally blind.
- Cataract, posterior uveitis, and retinal detachment were key predictors of poor outcomes.
Conclusions:
- Pediatric uveitis poses significant challenges in treatment and follow-up.
- Visual outcomes remain guarded, emphasizing the need for proactive management and early intervention.
Purpose:
This study aimed to describe visual outcomes in cases of pediatric uveitis in an Indian population and to analyze various factors affecting these outcomes.
Methods:
Single-center, retrospective chart review of 277 cases of uveitis in patients under the age of 18 years. Variables assessed included age and sex distribution, anatomical location of uveitis, systemic associations, complications, and various treatment strategies used, including long-term immunomodulation and surgical management of complications if required. The main outcome was the final visual acuity.
Results:
At the final visit, 51.5% of the eyes showed improvement in the final visual acuity, while vision remained stable in 28.7% and 19.7% of the eyes showed worsening of vision at the final follow-up. A total of 19.4% of patients were blind in at least one eye at the final visit, and 16 patients (5.77%) remained bilaterally blind at the final follow-up. The presence of cataract (p = 0), posterior uveitis (p = 0.005), and retinal detachment (p = 0.014) were the most significant risk factors for predicting worse visual outcomes. More than half (65.7%) of patients reported a complication at some point in their follow-up, and the most common complication was cataract. In total, 50.9% of patients required long-term immunomodulatory therapy.
Conclusion:
Pediatric uveitis remains a challenging condition to treat and follow-up, and the visual outcome remains guarded for most patients.
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