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Risk factors for the development of macular edema in children with uveitis
Ronit Friling1,2, Ori Berliner3, Maya Eiger-Moscovich3
1Unit of Pediatric Ophthalmology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Insights
In children with uveitis, non-anterior inflammation and vision impairment are key risk factors for developing macular edema (ME). Early detection through close follow-up is crucial for managing this common complication.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Inflammatory Diseases
Background:
- Uveitis is a significant cause of vision loss in children.
- Macular edema (ME) is a common complication of pediatric uveitis.
- Identifying risk factors for ME is crucial for timely intervention.
Purpose of the Study:
- To determine the risk factors for the development of macular edema (ME) in pediatric patients with uveitis.
- To identify independent predictors of ME in this population.
Main Methods:
- Retrospective study of 150 pediatric patients (264 eyes) with uveitis.
- Data collected on demographics, uveitis type, etiology, clinical findings, treatment, and ME development.
- Statistical analysis (univariate and multivariate) to identify risk factors.
Main Results:
- Macular edema (ME) developed in 23.9% of eyes over a mean follow-up of 15.3 months.
- Univariate analysis identified non-anterior uveitis location, band keratopathy, posterior synechiae, cataract, and vision impairment as risk factors.
- Multivariate analysis confirmed non-anterior uveitis and vision impairment as independent risk factors for ME.
Conclusions:
- Non-anterior uveitis location is strongly associated with the highest risk of ME in children.
- Complications like band keratopathy and posterior synechiae also increase ME risk.
- Close monitoring of children with uveitis is essential for early ME detection and management.
Aim:
To determine the risk factors for macular edema (ME) in children with uveitis.
Methods:
A retrospective study was conducted of 150 pediatric patients (264 eyes) with uveitis attending 2 tertiary medical centers. Data were collected from the medical files on demographics, type of uveitis, etiology, clinical findings, treatment, and time to development of ME. Risk factors for the development of ME were identified.
Results:
ME developed in 63 eyes (23.9%) over a mean period of 15.3 ± 2.95 months from diagnosis of uveitis, at a rate of 0.08 eyes per eye-year. On univariate analysis, risk factors for the development of ME were the non-anterior location of the inflammation (p=0.002), band keratopathy (p <0.0001), posterior synechiae (p=0.003), cataract (p=0.002), and vision impairment at presentation (p <0.0001). On multivariate analysis, non-anterior uveitis, which includes intermediate, pan, and posterior-uveitis, and vision impairment retained significance as independent risk factors of ME.
Conclusion:
Within the pediatric population with uveitis, non-anterior location is associated with the highest risk of ME, followed by the presence of complications, such as band keratopathy and posterior synechiae. These findings indicate a need for close follow-up in children with uveitis for early detection of ME.
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