An Overview of Pediatric Uveitis

Tuğal-Tutkun, İlknur

doi:10.5152/turkarchpediatr.2023.23086

Cited by 7 publications

(12 citation statements)

References 74 publications

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“…In contrast, Behcet’s disease emerged as the most common systemic disorder among children with uveitis, with a rate of 10.0% (n = 8). Notably, about half of the pediatric uveitis cases in various studies and approximately one-third of cases in the UK lacked an identifiable cause [ 17 , 18 ]. In our study, 40.0% (n = 33) of cases remained idiopathic, a proportion similar to findings in China, Japan, and Korea [ 1 , 2 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Globally, the prevalence of infectious uveitis varies widely, ranging from 3.5% in the USA to 58.0% in Colombia [ 11 , 20 ]. In regional contexts such as Turkey, the incidence hovers around 15.6% [ 17 ]. Toxoplasmosis emerged as the predominant etiology for infectious uveitis in many studies, while Tuberculosis took precedence in India [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Uveitis Profile in Children and Its Impact on Vision at Queen Rania Children's Hospital

Otoum,

Al Adwan,

Haddad

et al. 2024

Cureus

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Aim: The aim of this study was to explore the patterns of pediatric uveitis and the types of ocular complications of uveitis and to determine the possible risk factors associated with visual impairment. Method: This was a cross-sectional study conducted at Queen Rania Children's Hospital between June 2020 and June 2023. All children diagnosed with uveitis were enrolled in the study. After collecting data from the patients and reviewing their medical records regarding age, gender, and past ocular and medical history, the patients were subjected to a detailed ophthalmic exam including best-corrected visual acuity (BCVA). Anterior segment exam using the slit lamp, intraocular pressure exam using Goldmann applanation tonometry, and posterior segment exam using 78 and 90 diopter Volk lenses were performed. Patients with other ocular diseases that affected visions not related to uveitis were excluded from the study. Results: A total of 82 children, accounting for 130 eyes, were enrolled in this study, with ages ranging from 2 to 16 years (mean age 10.5±4.3 years). Among them, 27 were males, constituting 32.9% of the participants. Unilateral uveitis was observed in 34 eyes, representing 26.2% of cases. The mean age of uveitis onset was 6.9±1.9 years, and the mean disease duration was 4.8±0.4 years. The majority of cases i.e. 90.8% (n = 74) were non-infectious, with 92.3% (n = 76) classified as non-granulomatous and 79.2% (n = 65) categorized as chronic. Anterior uveitis was the most prevalent site of inflammation in 70.8% of cases (n = 58), followed by panuveitis in 20.0% of cases (n = 16), intermediate uveitis in 6.2% of cases (n = 5), and posterior uveitis in 3.0% of cases (n = 2). The cause of uveitis could not be identified in 40.0% (n = 33) of cases. Juvenile idiopathic uveitis emerged as the most commonly known disorder associated with uveitis in 40.0% (n = 33) of cases. Complications were identified in 52.3% (n = 43) of cases, with posterior synechiae being the most prevalent; 26.9% (n = 22) demonstrated an improvement in BCVA, while 21.5% (n = 18) experienced a decline in BCVA relative to the initial assessment Conclusion: Pediatric uveitis tends to manifest as anterior, chronic, bilateral, and non-granulomatous. Higher frequencies of severe visual impairment are linked to panuveitis, infectious and granulomatous uveitis, early-onset, long-duration cases, and male gender. The use of biologics has a positive effect, significantly improving or preserving visual acuity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uveitis Profile in Children and Its Impact on Vision at Queen Rania Children's Hospital

Otoum,

Al Adwan,

Haddad

et al. 2024

Cureus

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confidence: 99%

“…We successfully treated them with tumor necrosis factorα inhibitors (TNFi). [1][2][3][4][5] In clinical practice, physicians should be aware of the underlying severity of pediatric uveitis. 3 In this context, we emphasized severity of pediatriconset, non-infectious refractory chronic uveitis without JIA, previously referred to as juvenile chronic iridocyclitis (JCI).…”

mentioning

confidence: 99%

“…[1][2][3][4][5] In clinical practice, physicians should be aware of the underlying severity of pediatric uveitis. 3 In this context, we emphasized severity of pediatriconset, non-infectious refractory chronic uveitis without JIA, previously referred to as juvenile chronic iridocyclitis (JCI). 1All three patients were referred to us by the Ophthalmology Department of our hospital.…”

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Be aware of severe juvenile chronic iridocyclitis without evidence of arthritis: Juvenile chronic iridocyclitis revisited

Tokutake,

Hashimoto,

Fujita

et al. 2023

Int J of Rheum Dis

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Be aware of severe juvenile chronic iridocyclitis without evidence of arthritis: Juvenile chronic iridocyclitis revisited Dear Editor, Although the etiology of juvenile non-infectious uveitis varies, 1-3 its clinical course is sometimes refractory and carried a risk of poor visual outcome. [2][3][4][5] Juvenile idiopathic arthritis (JIA) -associated uveitis is an example of such a case. 2-8 However, some children with severe chronic uveitis that is very similar to JIA-associated ocular lesions do not exhibit any evidence of arthritis throughout the clinical course. 1,2 We treated three children with severe idiopathic uveitis without evidence of JIA. One patient required repeated surgical procedures for the sequelae of persistent ocular inflammation. Although all patients were treated with topical and systemic corticosteroids combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF), ocular inflammation was not adequately controlled. We successfully treated them with tumor necrosis factorα inhibitors (TNFi). [1][2][3][4][5] In clinical practice, physicians should be aware of the underlying severity of pediatric uveitis. 3 In this context, we emphasized severity of pediatriconset, non-infectious refractory chronic uveitis without JIA, previously referred to as juvenile chronic iridocyclitis (JCI). 1All three patients were referred to us by the Ophthalmology Department of our hospital. The patients had already received oral prednisolone and topical treatment; however, their ocular inflammation persisted. Patient 1 was a 13-year-old Japanese boy with a 6-year history of bilateral refractory chronic iridocyclitis.Aggressive regional treatment (topical betamethasone and periocular glucocorticoids plus intravitreal anti-VEGF administration) and oral prednisolone had been initiated. Then, we initially treated him with cyclosporin A (125 mg daily with the peak blood level of the

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Clinical characteristics of pediatric noninfectious uveitis and risk factors for severe disease: a single-center study

Koru,

Esen,

Turkyilmaz

et al. 2024

Clin Rheumatol

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Objectives We aimed to present the demographic, clinical, laboratory, and treatment data of children with non-infectious uveitis and to evaluate the risk factors for the development of complications and the need for biological treatment. Method Patients diagnosed with non-infectious uveitis in childhood and followed up for at least 1 year were included in the study. Demographic data, including age, gender, age at diagnosis, uveitis in first-degree relatives, and rheumatologic diseases, were obtained retrospectively from medical records. The presence of complications or the need for biologic therapy was considered a composite outcome suggesting severe disease. Results The study included 123 patients (female: n = 59, 48%). The mean age at diagnosis was 14.89 ± 4.86 years. Uveitis was symptomatic in 104 patients (84.6%). Approximately one-quarter of the patients had at least one rheumatic disease (n = 35, 28.5%), the most common being juvenile idiopathic arthritis. Thirty-three patients (26.8%) had anti-nuclear antibody positivity. Biologic agents were needed in 60 patients (48.8%). Complications developed in 14 patients (11.4%). Early age at disease onset (aOR, 0.875; 95% C.I. 0.795–0.965, p = 0.007) and female gender (aOR, 2.99; 95% C.I. 1.439–6.248, p = 0.003) were significantly associated with the need for biologic treatment, while Behçet’s disease (BD) was strongly associated with uveitis-related complications (aOR, 14.133; 95% C.I. 2.765–72.231, p = 0.001). Conclusion We suggest that among pediatric patients with non-infectious uveitis, females, those with an early age of disease onset, and those with BD need to be closely monitored due to a significantly increased risk of severe disease. Key Points• Limited data exist on the clinical course of non-infectious uveitis in children and the associated risk factors for severe disease.• Our study reveals that nearly a quarter of pediatric patients with non-infectious uveitis also have a rheumatic disease.• Among pediatric patients diagnosed with non-infectious uveitis, we observed an increased risk of severe disease in those with an earlier onset age, in female patients, and in those diagnosed with Behçet’s disease.

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An Overview of Pediatric Uveitis

Cited by 7 publications

References 74 publications

Uveitis Profile in Children and Its Impact on Vision at Queen Rania Children's Hospital

Uveitis Profile in Children and Its Impact on Vision at Queen Rania Children's Hospital

Be aware of severe juvenile chronic iridocyclitis without evidence of arthritis: Juvenile chronic iridocyclitis revisited

Clinical characteristics of pediatric noninfectious uveitis and risk factors for severe disease: a single-center study

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