Analysis of pediatric uveitis cases at a tertiary referral center.
OBJECTIVE
To analyze demographics, anatomic data, diagnoses, systemic associations, and visual outcomes of pediatric patients in a large tertiary eye center.


METHODS
Retrospective cohort study.


METHODS
The records of 1242 patients with uveitis referred to the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary (MEEI) from 1985 to 2003 were reviewed retrospectively. Two hundred sixty-nine patients 16 years and younger were identified.


RESULTS
Among 269 children with uveitis, 53.5% were girls, 82% were Caucasian, and 82% were born in the United States. Mean age was 8 years (standard deviation, 3.8; range, 1-16). Anterior uveitis represented 56.9% of cases; intermediate, 20.8%; panuveitis, 16%; and posterior, 6.3%. Nongranulomatous (77.6%) and noninfectious (85.7%) were the most frequent types of inflammation. The process was bilateral in 74.4% of patients. Mean follow-up was 22 months, with mean age of 8 years at diagnosis. Mean duration of uveitis at the time of presentation at the MEEI was 2 years. The range of time between the diagnosis of uveitis and referral was 1 day to 5.6 years. The length of time between diagnosis of uveitis and the referral to the tertiary center strongly correlated with the complication rate and degree of visual impairment in our study. The longer the time before the patients were seen by the uveitis expert, the worse the visual outcomes. No systemic associations were found in 58% of patients, juvenile idiopathic arthritis was responsible for 33% of cases, 8% of patients had other systemic associations, and 1% had tubulointerstitial nephritis uveitis syndrome.


CONCLUSIONS
Uveitis remains a serious cause of morbidity and visual loss in children. Timely referral to uveitis specialists in the tertiary referral centers may lead to improved visual outcomes in children with chronic uveitis.
Kump
Leila I
LI
Ocular Immunology and Uveitis Foundation, Boston, Massachusetts, USA.
Cervantes-Castañeda
René A
RA
Androudi
Sofia N
SN
Foster
C Stephen
CS
D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009885:Ophthalmology; D010045:Outpatients; D012017:Referral and Consultation; D012189:Retrospective Studies; D014605:Uveitis / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D014792:Visual Acuity