Long-term Follow-up of Intermediate Uveitis in Children

Boer, Joke de; Berendschot, Tos T. J. M.; Does, Patricia van der; Rothová, Aniki

doi:10.1016/j.ajo.2005.09.035

Cited by 78 publications

(84 citation statements)

References 19 publications

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“…They also observed an IR of relapse of 9.7 episodes per 100 eye-years, affecting only 24% of the eyes at risk for relapsing [20]. Compared with these results, overall, our rates of remission were lower than the ones published in studies analyzing only pediatric IU [10, 13] (regardless of the definition we used), but higher than the one published by Kempen et al [20], even when compared with the subgroup of those younger than 18 (IR 8.1).…”

Section: Discussioncontrasting

confidence: 53%

“…de Boer et al [10] studied the rate of remission in 32 Dutch patients (62 eyes) with idiopathic IU, during a mean follow-up time of 4.5 years. Using a more stringent definition of remission (absence of inflammation in any eye chamber without medication for at least 1 year), they observed a mean time to remission of 6.4 years, with 19, 47, and 90% of the patients achieving this outcome at 3, 5, and 8 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Sensitivity analyses were performed to assess the influence of (a) the use of optical coherence tomography in the IR of CMO, (b) the change in the rating system of ocular inflammation in the disease activity-related outcomes, and (c) the IR of remission using the previously published definition of de Boer et al [10, 13] (see online suppl. material, Sensitivity Analysis, sections a, b, and c, respectively).…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, in this age group, IU may be associated with a worse prognosis and a higher risk of visual loss [4, 10, 13-18], due to a greater difficulty to perform the ocular examination, an asymptomatic course, a higher risk of severe adverse drug reactions, or a more aggressive disease. Therefore, close monitoring and convenient therapeutic management of IU is essential to preserve the visual function of these patients, considering its chronic or recurrent course [14].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have analyzed the evolution of disease activity of pediatric IU in terms of remissions and relapses [3, 10, 13, 14, 20], although different outcome definitions and methodologies were used, resulting in heterogeneous observations.…”

Section: Introductionmentioning

confidence: 99%

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Disease Remission in Children and Adolescents with Intermediate Uveitis: A Survival Analysis

et al. 2017

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Purpose: To report the incidence rate (IR) of remission in pediatric noninfectious intermediate uveitis (IU). Methods: Longitudinal retrospective cohort study, including 19 patients (32 eyes) between 1985 and 2014, followed-up until loss or January 2016. Remission was defined following the Standardization of Uveitis Nomenclature workshop criteria, prolonged remission as a remission spanning 12 months and until the end of follow-up, and relapse as recurrence of inflammatory activity in an eye in remission. Results: Median follow-up time was 6.3 years. IRs (95% confidence interval) for remission, relapse, and prolonged remission were 18.6 (13.1–26.5), 32.3 (20.6–50.7), and 6.7 (3.8–11.9) episodes per 100 eye-years, respectively. 48% of eyes relapsed in the first year following remission. 25 and 50% of eyes achieved prolonged remission after 5 and 10 years of follow-up, respectively. Conclusions: Inflammatory relapses may be frequent in noninfectious IU affecting children and adolescents, appearing early after remission. Also, prolonged remission seems infrequent, being achieved late during follow-up.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disease Remission in Children and Adolescents with Intermediate Uveitis: A Survival Analysis

et al. 2017

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Clinical Presentation, Management, and Long‐Term Outcome of Pars Planitis, Panuveitis, and Vogt‐Koyanagi‐Harada Disease in Children and Adolescents

Reiff

2020

Arthritis Care & Research

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Objective. Chronic uveitis is a common manifestation of pediatric rheumatologic conditions and may result in irreversible blindness and long-term disability. While chronic anterior uveitis is the most commonly encountered ocular manifestation of rheumatic disease, little is known about the clinical presentation, management, and long-term outcome of more complex eye conditions such as pars planitis (PP), panuveitis (PU), and Vogt-Koyanagi-Harada disease (VKH). The present study was undertaken to comprehensively assess the long-term safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and biologics for the treatment of pediatric and adolescent patients with PP, PU, and VKH. Methods. We retrospectively reviewed a cohort of 75 children and adolescents with idiopathic PP (n = 50), PU (n = 11), and VKH (n = 14) followed by the Pediatric Rheumatology Core at Children's Hospital Los Angeles and evaluated referral patterns, clinical presentation, treatment response, and long-term clinical outcome. Results. Patients were followed for an average of 52 months. The mean age at disease onset was 10 years. Bilateral eye involvement was seen in 87% of the patients. At first presentation to an ophthalmologist, glaucoma was noted in 21%, and vision loss (<20/40) in 87% of patients, while legal blindness (≤20/200 in the better-seeing eye) was diagnosed in 18 of 75 (24%) patients (PP 22%, PU 36%, and VKH 21%). The average referral time to a pediatric rheumatologist was 13 months (range 1-96 months). Topical steroids were used in all patients, but 98% of patients required additional DMARDs, and 73% required therapy with biologics. After a mean of 52 months, 35% of patients across all disease groups had significant vision loss or were blind, and only 28% were in clinical remission without medications. The worst outcome was observed in children with PU. Application of regression analysis demonstrated that young age at onset, delayed referral to a pediatric rheumatologist, and chronic disease were strong predictors for the risk of long-term blindness. Conclusion. PP, PU, and VKH involve a high risk of permanent vision loss and should be managed by a skilled rheumatologist as early and as aggressively as possible.

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