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Pediatric Uveitis in a Tertiary Referral Center in East China: Clinical Patterns and Visual Outcomes
Boya Lei1,2,3,4, Xianjin Zhou5, Ruiping Gu1,2,3,4
1Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Insights
Pediatric uveitis is often chronic, noninfectious, and affects the anterior part of the eye. Most children required systemic therapy, but visual acuity improved in the majority of cases.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Immunology
Background:
- Pediatric uveitis presents unique challenges in diagnosis and management.
- Understanding clinical patterns is crucial for effective treatment strategies.
- Tertiary referral centers play a vital role in managing complex pediatric eye conditions.
Purpose of the Study:
- To characterize the clinical spectrum of pediatric uveitis.
- To evaluate visual outcomes in children with uveitis.
- To identify common etiologies and treatment approaches in East China.
Main Methods:
- Retrospective case series analysis.
- Review of clinical records from January 2014 to July 2021.
- Inclusion of 283 pediatric patients with uveitis.
Main Results:
- Predominance of chronic (62.9%) and noninfectious (81.3%) uveitis, primarily anterior (54.8%).
- Common causes included idiopathic chronic anterior uveitis and juvenile idiopathic arthritis-associated uveitis; ocular toxocariasis was the leading infectious etiology.
- Ocular complications occurred in 53.0% of patients; 66.8% received systemic immunosuppressive therapy.
- Visual acuity improved or was preserved in 95.2% of patients with recorded follow-up data.
Conclusions:
- Pediatric uveitis is predominantly chronic, noninfectious, and anteriorly located.
- Most patients necessitate systemic immunosuppressive therapy, including biological agents.
- Effective management strategies led to favorable visual outcomes in most cases.
Abstract:
Background: To describe the clinical patterns and visual outcomes of pediatric uveitis at a tertiary referral center in East China. Methods: Retrospective case series. Clinical records of patients with pediatric uveitis who presented between January 2014 and July 2021 were reviewed. Results: The children included (n = 283; 146 females, 137 males) had a mean age at presentation of 10.6 ± 3.5 years. There was a predominance of chronic (62.9%), noninfectious (81.3%) disease, and anterior uveitis was the most common uveitis type (54.8%). Idiopathic chronic anterior uveitis (17.3%) and juvenile idiopathic arthritis (JIA)-associated anterior uveitis (16.3%) were the most common noninfectious types; ocular toxocariasis (14.8%) and viral retinitis (1.4%) were the most common infectious etiologies. Ocular complications were observed in 53.0% of patients during follow-up. Systemic immunosuppressive therapy was administered to 66.8% of patients, 67.2% of whom required immunosuppressive drugs and/or biological agents (127/189 children). Surgical treatment was conducted in 38 (13.4%) patients. Improvement or preservation of visual acuity was observed in 95.2% of patients for whom follow-up visual acuity was recorded (179/188 patients). Conclusions: Pediatric uveitis was predominantly chronic and noninfectious, with anterior involvement. Systemic therapy was required by most patients, and most eyes showed improved visual acuity.
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