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S. Vandamme, M. Miyara, A.–M. Prieur, N. Cassoux, C. Fardeau, M. Debré, P. Quartier, P. LeHoang, B. Bodaghi; Epidemiology of Pediatric Uveitis in a Tertiary Eye Care Center: . Invest. Ophthalmol. Vis. Sci. 2006;47(13):690.
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© ARVO (1962-2015); The Authors (2016-present)
To report frequency, clinical features and etiologic characteristics of pediatric uveitis managed in a tertiary eye care center.
Retrospective observational case series of children referred for the first time in 2001 for diagnostic and therapeutic management of uveitis. A review of type and prevalence of uveitis according to the International Uveitis Study Group criteria, clinical features, complications and laser flare photometry values was obtained. OCT and fluorescein angiography were performed in the face of posterior and intermediate uveitis
There were 45 patients out of 670 new cases of uveitis (6.8%), with a F/M ratio of 1.3. Mean age was 8.4 years (range 4 to 14). The disease was bilateral in 56 % and unilateral in 44 % of cases. Noninfectious uveitis was the most frequent type of presentation (80 %). Intermediate uveitis (IU) accounted for 30% followed by posterior uveitis (PU), anterior uveitis (AU) and panuveitis (PanU), respectively 27%, 25% and 18% of cases. An etiologic orientation was established in 51% of cases, especially 73% of children with anterior uveitis, 59 % of those with posterior uveitis; 57 % of those with panuveitis and 28 % of those with intermediate uveitis. Juvenile idiopathic arthritis (JIA) and toxoplasmosis were the most frequent associated conditions, respectively 15.5 % and 11.1 % of cases. The other etiologies included: sarcoidosis (6.6%), bartonellosis (4.5%) Vogt–Koyanagi–Harada syndrome (4.5%), Lyme disease (2.2%), Behçet disease (2.2%), spondylarthropathy (2.2%) and toxocariasis (2.2%). Papillitis was present in 30 % of cases (25 % of PU, 29% of IU and 43 % of PanU). Cataract, band keratopathy and macular edema were present in respectively 28.8%, 28.8% and 24.5% of cases. Systemic corticosteroids were initially used in 45 % of cases according to the severity of ocular inflammation, and an immunosuppressive regimen was necessary in 13.3 % of cases.
Uveitis remains a serious cause of morbidity and visual loss in children. JIA remains the first etiology of pediatric uveitis and children should be referred more rapidly to multidisciplinary and specialized centres in order to initiate systemic therapy and avoid the occurrence of severe complications. Infectious conditions should be excluded before any corticotherapy and immunosuppression.
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