title: Treatment strategies for childhood noninfectious chronic uveitis: an update.
abstract: BACKGROUND
  Uveitis is an inflammatory disorder involving inflammation of the uveal tract. It is classified as anterior, intermediate, posterior or panuveitis, depending on the part of eye affected by the inflammatory process. In children, noninfectious, chronic uveitis is a relatively uncommon but serious disease, with the potential for significant long-term complications and possible blindness. Although frequently associated with an underlying systemic disease, for example, juvenile idiopathic arthritis, a significant number of cases in children show no associated signs or symptoms and are labeled as idiopathic.
  
  
  RESULTS
  We reviewed the available literature. Taking into account this evidence, an anti-inflammatory therapy based on an immunomodulatory approach seems a reasonable strategy for noninfectious chronic uveitis, in children as well as in adults. Due to a lack of controlled studies regarding uveitis in children, immunosuppressive strategy is supported only at evidence level III. Our aim is to review the currently available medical strategies for the treatment of childhood sight-threatening chronic uveitis.
  
  
  CONCLUSIONS
  Uveitis in children can be severe. Methotrexate is the drug of choice for recalcitrant cases, and biologic therapies can be useful in selected situations.
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simonini
authors.forename: Bruno
authors.initials: B
authors.lastname: Frediani
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pagnini
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
mesh_terms: D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use; D012720:Severity of Illness Index; D014605:Uveitis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D008727:Methotrexate