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Clinical profile and treatment outcomes in pediatric uveitis - A series from South India
1Department of Uvea and Ocular Inflammation, Prabha Eye Clinic and Research Centre and Vittala International Institute of Ophthalmology, Bengaluru, Karnataka, India.
Insights
Pediatric uveitis in South India often presents with noninfectious causes like idiopathic or tuberculosis. Early diagnosis and aggressive, multidisciplinary management are crucial for improving visual outcomes and preventing complications such as cataracts.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Immunology
Background:
- Pediatric uveitis is a significant cause of visual impairment in children.
- Understanding the clinical spectrum and outcomes is vital for effective management.
- Tertiary eye care centers play a crucial role in managing complex cases.
Purpose of the Study:
- To analyze the clinical characteristics of pediatric uveitis.
- To evaluate treatment strategies and visual outcomes.
- To identify challenges in managing pediatric uveitis in South India.
Main Methods:
- Retrospective analysis of 132 pediatric uveitis cases (206 eyes) from 2012-2022.
- Classification based on Standardization of Uveitis Nomenclature criteria.
- Evaluation of demographics, clinical presentation, management, and visual acuity.
Main Results:
- Noninfectious uveitis (70.45%) was more common than infectious (e.g., tuberculosis).
- Cataract (25.24%) and posterior synechiae (21.35%) were frequent complications.
- Significant visual acuity improvement was observed post-treatment (0.81 to 0.49 logMAR, P=0.002).
Conclusions:
- Pediatric uveitis requires specialized, aggressive management compared to adult cases.
- Early diagnosis and a multidisciplinary approach are essential for better visual prognosis.
- Addressing complications like cataracts is key to successful treatment outcomes.
Purpose:
The purpose of the study was to look at the clinical spectrum, treatment options, and visual outcomes in a large cohort of pediatric uveitis from a tertiary eye care center in South India.
Methods:
This is a retrospective study carried out at a tertiary eye center in South India. Cases of pediatric uveitis between January 2012 and June 2022 were retrieved from the hospital's medical database. Uveitis was classified according to the Standardization of Uveitis Nomenclature criteria. Demographic details, clinical presentation, complications, medical and surgical management, and visual outcome were evaluated.
Results:
Two hundred and six eyes of 132 cases were included, with a median age of 12 years. The male to female ratio was 1:1. Bilaterality was seen in 63.1% of cases. The mean duration of uveitis was 11.5 ± 18.5 months, and the mean follow-up period was 20.5 ± 25.1 months. Noninfectious uveitis was seen in 70.45% cases. Most common etiology in the noninfectious group was idiopathic (27.3%), while in the infectious group, it was tuberculosis (TB; 14.4%). Immunomodulators were used in 43.9% and biologics in 10.9% of cases. Most common complications were cataract (25.24%) and posterior synechiae (21.35%). Surgical procedures were done in 12.62%. The mean visual acuity was 0.81 ± 1.14 log of minimum angle of resolution (logMAR) at presentation and 0.49 ± 0.87 logMAR at the end of the study ( P = 0.002).
Conclusion:
Pediatric uveitis poses a challenge in comparison to adult uveitis. Our study highlights the need for early diagnosis and aggressive management to prevent sequelae. Multidisciplinary approach is a key in improving the overall visual prognosis.
