Elsevier

Ophthalmology

Volume 112, Issue 7, July 2005, Pages 1287-1292
Ophthalmology

Original Article
Analysis of Pediatric Uveitis Cases at a Tertiary Referral Center

Paper presented at: American Academy of Ophthalmology meeting (Uveitis and Ocular Inflammation section), October 25, 2004; New Orleans, Louisiana.
https://doi.org/10.1016/j.ophtha.2005.01.044Get rights and content

Objective

To analyze demographics, anatomic data, diagnoses, systemic associations, and visual outcomes of pediatric patients in a large tertiary eye center.

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.

Section snippets

Materials and Methods

All clinical records of patients referred to the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary (MEEI) from January 1985 to December 2003 were reviewed. Two hundred sixty-nine children, ≤16 years old, were identified. The following data were entered in the computer database for analysis: date of birth, gender, race, country of birth, ages at diagnosis of uveitis and presentation to the tertiary center (MEEI), total follow-up time at our institution, clinical

Results

All the patients were referred from various medical sites with an established or suspected diagnosis of uveitis. Among 269 children with uveitic syndromes, 82% were Caucasian; 10.4%, Hispanic; 4.6%, African American; and 3%, Asian (Table 1). Caucasian race predominated in all uveitis disease entity groups. However, Asians had the majority of cases in the panuveitis subgroup (n = 5/8 [62.5%]) as opposed to other races, where anterior uveitis was the most common type (Table 1). No significant

Discussion

We conducted this study because there have been no original published reports on patterns of pediatric uveitis in the United States since 1996. A Medline search conducted on April 2, 2004 using the keywords pediatric and uveitis revealed that the current study is the largest published pediatric series over the last decade in the Western world, and also one of the largest published in the literature since 1964. The weakness of such studies is that most of them are retrospective in nature, and

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Manuscript no. 2004-238.

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