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Pediatric uveitis inflammation control required tight classification, collaboration
Strict etiology classifications and close cooperation between pediatric rheumatologists and ophthalmologists contributed significantly to early inflammation control and long-term prognosis of pediatric uveitis, according to a retrospective data analysis.
Researchers at Lausanne University Hospital in Switzerland evaluated the demographics, etiologies, complications, treatments and visual prognoses of pediatric uveitis patients (median age, 9 years) who initially presented between January 2000 and December 2009.
Using the International Uveitis Study Group classification, 79 children (39 girls) were classified based on inflammation location. Inflammatory (69.6%) and infectious (30.4%) etiology groups were created. All patients were given a full ophthalmic examination, and systemic diseases were diagnosed by a pediatric rheumatologist. Median follow-up was 1.8 years.
The primary diagnoses were idiopathic uveitis (34.2%), juvenile idiopathic arthritis-related uveitis (22.8%) and toxoplasmic retinochoroiditis (15.2%).
Fifty-one patients had involvement in both eyes and the course was acute in 30.4%, chronic in 60.8% and recurrent in 8.9%.
Compared with all patients, anterior uveitis patients (39.2%) were younger at disease-onset (median age 4.6 vs. 9 years). Intermediate uveitis occurred in 32.9%, posterior in 22.8% and panuveitis in 5.1% of cases.
“In comparison with previous series, our study shows a higher use of systemic treatments together with less complications and better visual outcome,” the researchers wrote. “These results emphasize the importance of early aggressive treatment for better long-term visual prognosis.”
Patient visual acuity (VA), measured during the last follow-up visit, was at least 8/10 in 72% of all eyes with a measureable VA. The most common severe complications were cataract (8%), ocular hypertension/glaucoma (8%) and macular fibrosis (4%).
Fifty-six percent of patients with inflammatory uveitis were given systemic steroids, and 24% were treated with biologics.
Disclosure: The researchers report no relevant financial disclosures.