Ocular complications of pediatric uveitis.
OBJECTIVE
To determine the cumulative proportion and the visual significance of ocular complications of pediatric uveitis.


METHODS
Cohort study.


METHODS
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.


METHODS
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.
Rosenberg
Krista D
KD
Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33101, USA.
Feuer
William J
WJ
Davis
Janet L
JL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014605:Uveitis / Q000145:classification / Q000150:complications*; D014786:Vision Disorders / Q000209:etiology*