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Ocular complications of pediatric uveitis.

Abstract：

PURPOSE:To determine the cumulative proportion and the visual significance of ocular complications of pediatric uveitis. DESIGN:Cohort study. PARTICIPANTS:Patients with onset of endogenous or infectious uveitis before or at age 16 years. METHODS:Retrospective review of existing records at a university-based uveitis clinic. MAIN OUTCOME MEASURES:Type and prevalence of complications related to uveitis, time to development of complications, and vision loss after initial diagnosis. RESULTS:There were 148 patients, 71 males and 77 females, with a mean age of 10.4+/-4.9 years (median, 10.3 years) for an estimated prevalence of pediatric uveitis of 13.8%. Noninfectious uveitis was present in 112 patients (75.7%); 105 (71%) patients had bilateral disease. Anterior uveitis accounted for 30.4%, intermediate uveitis for 27.7%, posterior uveitis for 23.7%, and panuveitis for 18.2% of patients. Patients were followed for a mean of 71.7 months (range, 0 months-44 years) after diagnosis. Approximately 34% of all patients had 1 or more complications at the time of first diagnosis of uveitis by an ophthalmologist, increasing to 61.6% by 3 months, 69.4% by 6 months, 75.2% by 1 year, and 86.3% by 3 years after diagnosis. There were a total of 617 complications of all types. Anterior and intermediate uveitis had a higher risk of band keratopathy (P = 0.005). Posterior and intermediate uveitis had a lower risk of cataract (P = 0.009) or posterior synechiae (P<0.001). Intermediate uveitis had a higher risk of cystoid macular edema compared with anterior or posterior uveitis (P = 0.002). The cumulative percentages (standard error) of patients with first loss to 20/200 or worse after diagnosis in the affected eyes of unilateral cases or in either eye of the bilateral cases were: 31.3% (3.9) at 1 month; 40.5% (4.1) at 6 months; 56.0% (4.3) at 24 months; and 69.6% (4.5) at 60 months. Fifty-four patients (48.2%) received systemic antiinflammatory or immunomodulatory therapy. Sixty-eight patients (45.9%) had ocular surgery, and 38 of these had ocular surgery in both eyes. CONCLUSIONS:Childhood uveitis is significant for numerous complications, many of which are vision threatening. Complications increase with duration of disease.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Rosenberg KD,Feuer WJ,Davis JL

doi

10.1016/j.ophtha.2004.06.014

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

2299-306

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(04)00959-5

journal_volume

111

pub_type

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Ocular complications of pediatric uveitis.