Pediatric Uveitis in a Well-Defined Population: Improved Outcomes with Immunosuppressive Therapy

Curragh, David; OʼNeill, Marie S.; McAvoy, C E; Rooney, Madeleine; McLoone, Eibhlin

doi:10.1080/09273948.2017.1305420

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…Children also tend to be diagnosed with uveitis at younger age, which may affect the overall prevalence. Girls were more commonly affected than boys in our cohort, which is in agreement with the previous studies (Paroli et al 2009; Rahimi et al 2016; Lonngi et al 2016; Curragh et al 2017). In contrast, male predominance has also been shown, for example, in India (Hamade et al 2009; Venkatesh & Takkar 2018).…”

Section: Discussionsupporting

confidence: 93%

“…In agreement with this, 89% of the uveitis cases in children were non‐infectious and only a minority of the cases in the present study were of infectious background. Several studies have shown that JIA accounts for 9–48% of the systemic association of paediatric non‐infectious uveitis (Hamade et al 2009; Rahimi et al 2016; Curragh et al 2017). In our cohort, the amount of children with uveitis associated with JIA was even higher, 61%, and only one fifth was idiopathic.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies from Southern Finland and other Nordic countries have revealed a prevalence of 16–25% in childhood uveitis within JIA patients depending on study population (Kotaniemi et al 1999; Kotaniemi et al 2001; Kotaniemi et al 2014; Nordal et al 2017). Paediatric uveitis has been estimated to affect three in 100 000 children worldwide (Hamade et al 2009; Paroli et al 2009; Rahimi et al 2016; Curragh et al 2017; Venkatesh & Takkar 2018).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, incidence and epidemiology of childhood uveitis

Siiskonen

Hirn

Pesälä

et al. 2020

Acta Ophthalmologica

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Purpose To analyse the prevalence, incidence and aetiology of paediatric uveitis. Methods A retrospective, population‐based cohort study of Finnish children with uveitis in Northern Ostrobothnia Hospital District in 2008–2017. The data included parameters for age, gender, age at diagnosis, laterality, chronicity, anatomical distribution of the disease, aetiology and systemic association. Results One hundred fifty patients aged <16 years (mean age 6.9 ± 3.9 years) with uveitis were included, out of whom 53% were girls. The first uveitis episode occurred at 1–6 years in 59%, and 62% of them were girls. In the age group of 7–15 years, boys were diagnosed with uveitis more frequently than girls (61% versus 39%, respectively). Seventy percent of the girls were diagnosed with their first uveitis episode at the age of 1–6 years, whereas only 48% of the boys were diagnosed at that age. The prevalence of uveitis increased from 64/100 000 children <16 years in 2008 (95% CI, 47.7–84.2) to 106/100 000 in 2017 (95% CI, 84.6–130.2). The incidence of childhood uveitis in 2008–2017 was 14/100 000 person‐years in children <16 years (95% CI, 11.3–16.5). Eighty‐seven percent of the cases were non‐infectious, 9% were infectious, and 3% had masquerade syndromes. Sixty‐one percent of patients had juvenile idiopathic arthritis (JIA). Conclusion The prevalence of paediatric uveitis has increased during the last decade in both genders. Uveitis is more frequent in girls, and they were diagnosed at a younger age than boys. Idiopathic cases and JIA accounted for a majority of aetiological features.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence, incidence and epidemiology of childhood uveitis

Siiskonen

Hirn

Pesälä

et al. 2020

Acta Ophthalmologica

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“…Despite numerous cases of PSUS reported since its original description in 1991, it is still an under-recognised condition [2]. In our paediatric uveitis population attending the Belfast Paediatric Uveitis Regional Service, PSU represented 11.6% of patients [18]. The pathophysiology is not well understood with the mechanism of inflammation unclear.…”

Section: Discussionmentioning

confidence: 97%

Post-streptococcal uveitis syndrome in a Caucasian population: a case series

Curragh

McAvoy

Rooney

et al. 2018

Eye

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We report on the largest consecutive series of Caucasian patients under 16 years of age with PSUS. We have demonstrated a seasonal preponderance with presentation typically in winter or spring. We report a novel finding of corneal endotheliopathy in one of our PSUS patients. We also report on the benefit of adalimumab in the management of severe cases of PSUS; use of biologics in this particular cohort of uveitis patients has not previously been reported. With aggressive treatment our patients achieved good visual outcomes comparable to other published series.

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“…These studies report that by the last follow up visit (5-10 years later), the prevalence of ocular complications increased to 45-58%, consisting of posterior synechia (10-37%), band keratopathy (17-19%), ocular hypertension (28%), glaucoma (9-12%), cataracts (19-29%), and macular edema (6-7%) [7,9,14,24]. Visual acuity equal to or worse than 20/200 remained unchanged (0-6%) [9,13,14]. By the last visit, 45-70% of these patients were on tumor necrosis factor (TNF)-α inhibitors such as adalimumab or infliximab, with or without methotrexate.…”

Section: Issues and Consequences Of Not Diagnosing In A Timely Mannermentioning

confidence: 99%

Improving quick and accurate diagnosis of childhood JIA-uveitis from a pediatric rheumatology perspective

Rodriguez-Smith

Yeh

Angeles‐Han

2020

Expert Review of Ophthalmology

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Introduction: Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease associated with uveitis. JIA-associated uveitis (JIA-U) is typically asymptomatic, chronic, and can lead to sight-threatening complications. This review will provide approaches to improve the diagnosis and outcomes of children with JIA-U. Areas covered:We will provide updates on risk factors for uveitis onset and ocular complications, improvements in the ophthalmic screening schedule for uveitis detection, and potential strategies to advance the diagnosis and monitoring of JIA-U using advanced ophthalmic imaging and diagnostic equipment and laboratory biomarkers. Expert opinion:There is a lack of high-quality research in JIA-U and few randomized controlled trials, underscoring the urgent need for further studies in this population. Early uveitis diagnosis combined with timely and appropriate treatment can improve visual outcomes. Improved knowledge of uveitis pathogenesis, risk factors for uveitis onset, measurement of uveitis outcomes, and optimal treatment are crucial.

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Pediatric Uveitis in a Well-Defined Population: Improved Outcomes with Immunosuppressive Therapy

Abstract: The etiology of uveitis in this pediatric population is mixed. With close monitoring, most patients maintain good vision.

Cited by 16 publications

References 15 publications

Prevalence, incidence and epidemiology of childhood uveitis

Prevalence, incidence and epidemiology of childhood uveitis

Post-streptococcal uveitis syndrome in a Caucasian population: a case series

Improving quick and accurate diagnosis of childhood JIA-uveitis from a pediatric rheumatology perspective

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