THU0532 Paediatric uveitis in french referral ophthalmologic centers: a descriptive analysis of 74 children

Abstract

BackgroundUveitis in children is rare. Intensive interactions between ophthalmologists and paediatric rheumatologists are needed in order to choose the best therapeutic strategies for severe uveitis attacks.ObjectivesDescribe a cohort of 74 patients with paediatric uveitis.MethodsRetrospective analysis of children followed for uveitis before 18, by one paediatric rheumatologist (SGC) for systemic treatments' management and members of 3 ophthalmologic departments specialized in uveitis care in children (AR, CT, ML and BB) in Paris, during the 2006–16 period.ResultsThere were 74 paediatric uveitis, 42 anterior (57%, group1), 16 intermediate (21%, gr2), 7 posterior (9%, gr3) and 9 pan-uveitis (12%, gr4). Gender was equal in gr2–4, but there were more females in gr1. At presentation, mean ages were 8.6±4.1, 9.8±3.9, 9.1±3.6 and 10±4.2 years old. Mean follow-up was 3.7±3.7 years. JIA was the leading cause of gr1 uveitis (45%); gr2–3 uveitis were idiopathic in 81% and 86%, respectively. In gr4, etiologies were found in 7 out of 9 patients (Behçet-3, JIA-2, BBS-1, TINU-1).Table 1ComplicationsI: Anterior uveitisII: Intermediate uveitisIII: Posterior uveitisIV: Panuveitis (42) 51%(16) 71%(7) 71%(9) 100% Cataracts25%21%44%Papilledema19%21%56%HTP/Glaucoma16%Macular edema29%33%Vitreous hemorr.21%33%Retinal detach.29%33%Blindness6% (n=2Uni)7% (n=1Uni)29% (n=2Bi)33% (n=2Uni+1Bi)Table 2TreatmentsI: Anterior uveitis (42)II: Intermediate uveitis (16)III: Posterior uveitis (7)IV: Panuveitis (9) High dose systemic steroid45% (19)80% (12)71% (5)100% (9)Synth DMARDs66% (27) (MTX-26, AZA-2)60% (9) (MTX, AZA)71% (5) (MTX, AZA)78% (7) (MTX, AZA, COL)SynthDMARDs + Biologics34% (14) (IFX-4, ADA-10)33% (5) (IFX-1, TCZ-1, IFN-4)43% (3) (IFX-2, IFN-1)33% (3) (IFX-3)Surgery18% (7) (cataracts – 5, glaucoma – 1, keratopathy – 1)20% (3) (cataracts – 3, vitrectomy – 1)063% (5) (cataracts – 2, glaucoma – 1, vitrectomy – 1, antiangio. inj.– 1)ConclusionsPaediatric uveitis induce a very high-level burden in children, even when anterior and sometimes despite optimal therapeutic management in tertiary care centers. Their early recognition and tight control in specialized units are absolutely required in order to decrease the level of definitive complications.Disclosure of InterestNone declared