Posterior synechia may predict cataract development in pediatric uveitis

The presence of posterior synechia at the time that uveitis is diagnosed in children with juvenile idiopathic arthritis-associated uveitis may be a risk factor in the development of early cataract requiring surgery, according to a retrospective study by researchers in the Netherlands.

"However, early treatment with [methotrexate] is associated with a mean delay in the development of cataract requiring surgery of 3.5 years," the study authors said.

Karen M. Sijssens, MD, and colleagues at University Medical Center Utrecht evaluated possible risk factors of cataract development in 53 children with juvenile idiopathic arthritis-associated uveitis. They published their results in the October issue of American Journal of Ophthalmology.

Of the 53 children, 27 had undergone cataract extraction. The researchers investigated the interval between the onset of uveitis and the first cataract extraction (U-CE interval) in relation to preoperative clinical characteristics, ophthalmologic characteristics and treatment strategies, according to the study.

Children with posterior synechia had a shorter U-CE interval than those without posterior synechia, the authors reported.

The researchers found no significant interval difference between children in whom either uveitis or arthritis was the first manifestation of juvenile idiopathic arthritis. They also found no significant interval difference between children treated either with or without periocular corticosteroid injections.

However, children treated with methotrexate had a longer U-CE interval than those who did not receive methotrexate, the authors noted.