Uveitis in children: Population‐based study in Finland

Abstract

ABSTRACT.Purpose: To investigate the incidence and prevalence rates of different types of uveitis in children, and to compare them with the rates in adults. Subjects and methods: For this population-based retrospective study the medical records of all residents of the district of Turku University Hospital with a diagnosis of uveitis seen at the Eye Clinic of Turku University Hospital during the years 1980-1982 and 1988 were reviewed. Results: A total of 1122 uveitis cases were identified, and 55 (4.9%) of them were children under 16 years. The incidence per 100 000 population per year for all uveitis cases in children was 4.3 (95% confidence interval [CI], 2.2 to 6.4), and the prevalence was 27.9 (95% CI, 17.1 to 38.6), which was significantly lower compared with the rates in adults (pΩ0.001 for incidence and prevalence). The vast majority of children, 50 (90.9%), had anterior uveitis (AU), and the incidence and prevalence rates of AU were significantly lower than in adults (pΩ0.001 for incidence and prevalence). Three (5.5%) children had posterior uveitis (PU), but there was no significant difference in the incidence and only marginally significant difference in the prevalence rate of PU in children compared with the rates in adults (pΩ0.33 for incidence, and pΩ0.07 for prevalence). Only one case (1.8%) was found with intermediate and one with panuveitis, but no new cases. The commonest diagnostic groups in children were AU associated with juvenile rheumatoid arthritis, idiopathic acute anterior uveitis, and idiopathic chronic anterior uveitis. Toxoplasmic retinochoroiditis was found in all of the PU cases with the incidence 0.3, and the prevalence 1.1, which did not differ significantly from the rates in adults (pΩ1.0 for incidence, and pΩ 0.48 for prevalence). Conclusion: Uveitis is rarer in children than in adults. However, in contrast to studies from tertiary referral centers, the distribution of different forms of uveitis in children in this population-based study seems to resemble the distribution in adults.

Juvenile idiopathic arthritis-associated uveitis

“…However, the risk of delayed diagnosis and onset of complications at a young age makes this an important clinical problem. The overall incidence of uveitis in the paediatric population, reported in a study from Finland, was 4.3 per 100,000/year and prevalence of 27.9 per 100,000 [5]. When broken down by aetiology, the prevalence of JIA-U among all causes of paediatric uveitis varies widely by referral centre, ranging from 15-67 % across centres in Europe, North America and Israel [4,[6][7][8][9].…”

Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis–associated uveitis: A consensus effort from the multinational interdisciplinary working group for uveitis in childhood

“…The prevalence of JIA is 50 -200 per 100,000 children (2,3), and in 10 -18% of patients, arthritis is accompanied by uveitis (3)(4)(5). JIA-associated uveitis has a wide spectrum of manifestations and severities (6 -11).…”

Proteomic Profile of Tears for the Diagnosis of Uveitis Associated with Juvenile Idiopathic Arthritis: Setting Targets to Achieve Results

“…В год в среднем выявляется 4,3-6,9 новых случая уве-ита на 100 000 населения при общей распростра-ненности около 30 случаев на 100 000 [23,54,70]. До 6 % всех увеитов у взрослых начинаются в дет-стве [67].…”

“…До 6 % всех увеитов у взрослых начинаются в дет-стве [67]. Диагностика и лечение увеита у детей, составляющих всего 5 % от всей численности стра-дающих увеитом в популяции [70], представляют большую проблему, поскольку течение заболевания часто маломанифестно [9], дети, как правило, не жа-луются на ухудшение зрения и настроены негативно по отношению к активному офтальмологическому осмотру. В результате до 30-40 % детей, страдаю-щих увеитом, в значительной степени теряют зре-ние [4,107].…”

“…Причины увеита у детей, как и у взрослых, чрезвычайно разнообразны, причем неинфекци-онные увеиты являются наиболее частой формой, а в 60 % случаев причина заболевания вообще оста-ется нераспознанной [9,23,54,70,79,94].…”