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Barbara Giampietro, Fernanda Maria silveira Souto, Julia Thiemi Takiuti, Lucia Maria Arruda Campos, Carlos Eduardo Hirata, Joyce H Yamamoto; Analysis of pattern and clinical features of pediatric uveitis cases at a tertiary referral center in São Paulo, Brazil. Invest. Ophthalmol. Vis. Sci. 2018;59(9):172.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze clinical features, systemic associations, treatment and visual outcomes of uveitis in children and to identify the pattern of childhood uveitis in a referral center in São Paulo, SP, Brazil.
This is a retrospective, descriptive study, including patients from 0 to 16 years old with uveitis and a minimum follow-up of six months, attended at Uveitis Service, Hospital das Clinicas HCFMUSP, between April and September 2017. Data retrieved and analyzed were: ocular and systemic symptoms; actual age, ages at diagnosis of uveitis and at first visit to the tertiary center, gender, laterality, duration of follow-up; visual acuity at presentation and at last visit, intraocular pressure, ocular findings at slit-lamp biomicroscopy and indirect ophthalmoscopy; local and/or systemic medical therapies; ocular surgeries. Ocular complications were recorded if they occurred at any time point. Descriptive statistics are presented. This study was approved by the Institutional Ethics Committee and followed the Helsinki declaration.
Bilateral involvement (90%), asymptomatic (56%), recurrent/chronic disease (85%) were main disease characteristics in the 39 children (25F/14M) included. The majority of patients (74%) had visual acuity ≥ 20/60 in the better eye in the first visit with improvement in last evaluation; 55% were referred until 6 mo of uveitis diagnosis to this tertiary center. Anterior uveitis was the most common involvement (46%), followed by intermediate uveitis (26%). Juvenile idiopathic arthritis associated uveitis (41%) and intermediate uveitis (26%) were the principal non-infectious conditions (77%); ocular toxoplasmosis (8%) and toxocariasis (5%) were the most frequent infectious conditions (18%). Ocular complications were observed at the first visit in 46% and they were more frequent (90%) at last evaluation with incidence rate per eye-year of 0.096 for cataract and of 0.057 for ocular hypertension. Oral prednisone, immunosuppressant drug and/or biologic agent were used in 79% of children.Table below summarizes main pediatric uveitis characteristics at this tertiary center.
Pediatric patients with uveitis are referred early to this center and despite disease severity adequate management with systemic immunosuppressive therapy may preserve visual acuity.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Table. Characteristics of pediatric uveitis in a tertiary center, São Paulo, Brazil
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