Uveitis in Children and Adolescents

Chang, Margaret H.; Shantha, Jessica G.; Fondriest, Jacob J; Lo, Mindy S.; Angeles‐Han, Sheila T.

doi:10.1016/j.rdc.2021.07.005

Cited by 19 publications

(12 citation statements)

References 139 publications

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“…Up to 10% of all uveitis cases occur in children, 4 in whom anterior uveitis-either idiopathic or related to juvenile idiopathic arthritis-is most common. 5 Decreased vision is not always present in eyes with UME; some eyes can see remarkably well despite the presence of UME. 2 Dr Yeh: What is the role of fluorescein angiography (FA) in the evaluation of UME in eyes with uveitis?…”

Section: Dr Yehmentioning

confidence: 99%

Targeting the Suprachoroidal Space

2022

Retina

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Section: Dr Yehmentioning

confidence: 99%

Targeting the Suprachoroidal Space

2022

Retina

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“…Uveitis, an inflammatory condition affecting the uveal tract of the eye, poses a significant risk to vision and is a serious concern among children. Pediatric uveitis accounts for 10% of uveitis cases, with an incidence rate of 4.3 per 100,000 and a prevalence of 27.9 per 100,000 [ 1 , 2 ]. Alarmingly, over half of uveitis cases lead to ocular complications, and nearly one-third of afflicted children experience severe visual impairment [ 3 ].…”

Section: Introductionmentioning

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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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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“…The main causes of childhood uveitis are systemic inflammatory diseases (5-47%) followed by infectious etiologies (2-39%). In a relatively large part (25-60% of cases depending on series), clinical and biological work-up does not allow to find the causes of the ocular inflammation: It is then an idiopathic uveitis (1)(2)(3)(4). Treatment differs depending on the etiologies.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Leading to Anti-TNF Alpha Therapies in Pediatric Severe Uveitis

et al. 2022

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PurposePediatric uveitis is the leading cause of acquired child blindness, due to unremitting inflammation and long-term steroid exposition. Biotherapies with anti-tumor necrosis factor alpha (anti-TNFα) are effective in controlling inflammation for severe pediatric uveitis in recent studies. Major concern of anti-TNFα prescription is the balance between the severity of the disease and side effects of the drug. The aim of the present study is to describe a cohort of children with severe uveitis and to highlight the risk factors for a pejorative development that led to the prescription of anti-TNFα drugs.MethodA retrospective case-control study was carried out on children with uveitis associated with systemic inflammatory disease or idiopathic uveitis, with a minimum follow-up of 5 years. Anti-TNFα-treated patients (case) were studied and compared with patients who were not requiring anti-TNFα (control). Univariate logistic regression analyses were performed to compare both groups and determine the risk factors for anti-TNFα therapy.ResultsSeventy-three cases of pediatric uveitis were included, 13 cases and 60 controls. The risk factors associated with increased odds of anti-TNFα therapy were initial systemic disorder associated with uveitis [OR = 11.22 (1.37–91.85), p = 0.0241), family history of autoimmune diseases [OR = 9.43 (2.27–39.15), p = 0.0020], uveitis diagnosis before the age of 6 [OR = 4.05 (1.16–14.13), p = 0.0284], eye surgery [OR = 26.22 (2.63–261.77), p = 0.0054], ocular complications at the first slit lamp exam [OR = 67.11 (3.78–1191.69), p = 0.0042], low visual acuity at diagnosis (≥0.3 logMAR) [OR = 11.76 (2.91–47.62), p = 0.0005] and especially low binocular acuity at diagnosis (≥0.3 logMAR) [OR = 8.75 (1.93–39.57), p = 0.0048], panuveitis [OR = 9.17 (2.23–37.60), p = 0.0021], having positive ANA [OR = 3.89 (1.07–14.11), p = 0.0391], and positive HLA B27 [OR = 9.43 (2.27–39.16), p = 0.0020].ConclusionThose risk factors could be used to establish a new follow-up and treatment schedule for severe uncontrolled uveitis. This could help to better predict the best time to start anti-TNF therapy.

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Uveitis in Children and Adolescents

Cited by 19 publications

References 139 publications

Targeting the Suprachoroidal Space

Targeting the Suprachoroidal Space

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

Risk Factors Leading to Anti-TNF Alpha Therapies in Pediatric Severe Uveitis

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