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Paediatric non-infectious granulomatous uveitis: a retrospective cohort study
Ai Tien Nguyen1, Antoine Rousseau2,3, Bahram Bodaghi4
1Department of Paediatric Rheumatology, CeRéMAIA, ERN RITA Member, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Saclay University, Le Kremlin-Bicêtre, France.
Rheumatology (Oxford, England)
|May 6, 2024
Summary
Paediatric granulomatous uveitis (PGU) is a rare condition often diagnosed late, leading to poor vision. This study highlights idiopathic and sarcoid forms as serious, requiring early disease-modifying therapy for better outcomes.
Area of Science:
- Ophthalmology
- Rheumatology
- Paediatric Medicine
Background:
- Paediatric granulomatous uveitis (PGU) is a rare condition with significant diagnostic challenges and potential for poor visual outcomes.
- Lack of awareness contributes to delayed diagnosis and management difficulties in PGU.
Purpose of the Study:
- To evaluate the demographics, etiologies, complications, treatments, and visual prognosis of paediatric non-infectious granulomatous uveitis.
- To provide insights into the management of this rare paediatric condition.
Main Methods:
- Retrospective chart review of non-infectious PGU cases in children under 16 years old.
- Data collected from the Paediatric Rheumatology Unit, Bicêtre Hospital, France (2001-2023).
Main Results:
- The study included 50 patients (90 eyes); most cases were idiopathic (29) or sarcoidosis (15).
- Panuveitis (56%), bilateral involvement (84%), and chronic disease (84%) were common. Ocular complications affected 76% of eyes at diagnosis.
- Systemic corticosteroids (72%) and methotrexate (80%) were primary treatments. Remission or inactive disease was achieved in 91% of eyes by follow-up.
Conclusions:
- This is the largest cohort of PGU reported, predominantly idiopathic, with a high complication rate.
- Sarcoid and idiopathic panuveitis are severe, necessitating early initiation of disease-modifying therapy for improved patient management and visual prognosis.
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