title: Risk Factors for the Development of Cataract in Children with Uveitis.
abstract: OBJECTIVE
  To determine the risk factors for the development of cataract in children with uveitis of any etiology.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Two hundred forty-seven eyes of 140 children with uveitis were evaluated for the development of vision-affecting cataract. Demographic, clinical, and treatment data were collected between the time of presentation and the first instance cataract was recorded or findings at final follow-up. Main outcome measures included the prevalence of cataract and distribution by type of uveitis, incidence of new onset cataract time to cataract development, and risk factors for the development of cataract.
  
  
  RESULTS
  The prevalence of cataract in our cohort was 44.2% and was highest among eyes with panuveitis (77.1%), chronic anterior uveitis (48.3%), and intermediate uveitis (48.0%). The overall incidence of newly diagnosed cataract was 0.09 per eye-year, with an estimated 69% to develop uveitis-related cataract with time. The main factors related with cataract development were the number of uveitis flares per year (hazard ratio [HR] = 3.06 [95% confidence interval {CI}, 2.15-4.35], P < .001), cystoid macular edema (HR = 2.87 [95% CI, 1.41-5.82], P = .004), posterior synechia at presentation (HR = 2.85 [95% CI, 1.53-5.30], P = .001), and use of local injections of corticosteroids (HR = 2.37 [95% CI, 1.18-4.75], P = .02). Treatments with systemic and topical corticosteroids were not significant risk factors.
  
  
  CONCLUSIONS
  In this study, we found that development of cataract is common among pediatric eyes with uveitis and is most strongly related to the extent of inflammation recurrences and ocular complications. We suggest that controlling the inflammation, even using higher doses of systemic and topical corticosteroids, is of importance in preventing ocular complications, such as cataract.
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Department of Ophthalmology, Galilee Medical Center, Naharia, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Blum-Hareuveni
authors.affiliation: UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Seguin-Greenstein
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Kramer
authors.affiliation: Department of Ophthalmology, Galilee Medical Center, Naharia, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Hareuveni
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Sharon
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Friling
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Lazha
authors.initials: L
authors.lastname: Sharief
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Sue
authors.initials: S
authors.lastname: Lightman
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, Bnai Zion Medical Center, Technion, Israel Institute of Technology, Haifa, Israel. Electronic address: o.tomkins-netzer@ucl.ac.uk.
authors.forename: Oren
authors.initials: O
authors.lastname: Tomkins-Netzer
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D014792:Visual Acuity