Chronic anterior uveitis in children: clinical characteristics and complications.
OBJECTIVE
To describe clinical features of chronic anterior uveitis in children at presentation to a referral center (baseline); to identify relationships between demographic, medical, and ophthalmic factors at baseline; and to determine baseline factors that predict new complications and vision loss during follow-up.


METHODS
Retrospective case series.


METHODS
Studied were involved eyes of all children (age < or =16 years at disease onset) with chronic anterior uveitis who were examined by 1 clinician from 1993 through 2006. Cross-sectional analyses compared baseline findings. Relationships between potential risk factors and incident adverse events (new complications, vision loss) were studied by Kaplan-Meier and Cox proportional hazards regression models.


RESULTS
There were 115 patients (200 eyes) who met inclusion criteria. Follow-up (n = 83 patients) ranged from 0.4 to 157.5 months (median, 23.5 months). There were numerous strong relationships between 8 defined complications at baseline in pairwise comparisons. Flare was the inflammatory sign most consistently associated with complications at baseline. Baseline factors that predicted new complications during follow-up included age < or =3 years, elevated cells, elevated flare, keratic precipitates, signs of intermediate uveitis, and papillitis (all P < .043); factors that predicted vision loss included male gender, increased flare, signs of intermediate uveitis, papillitis, and baseline complications (all P < .015). Not related to new complications were presence of juvenile idiopathic uveitis and immunomodulatory therapy.


CONCLUSIONS
Chronic anterior uveitis in children is associated with various vision-threatening complications that occur in combinations. Complications develop early in the disease course. Patients with more severe disease at presentation are at increased risk of additional adverse events.
Holland
Gary N
GN
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. uveitis@jsei.ucla.edu
Denove
Christopher S
CS
Yu
Fei
F
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult
D007166:Immunosuppressive Agents