July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Changing biological disease modifying treatment for paediatric uveitis in the real world
Author Affiliations & Notes
  • Sophia Zagora
    Sydney Eye Hospital, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Lawrence Oh
    Sydney Eye Hospital, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Chu L. Nguyen
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Kevin Phan
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Eugene Wong
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Davinder Singh-Grewal
    Paediatric Rheumatology, Children's Hospital Westmead and Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Jeffrey Chaitow
    Paediatric Rheumatology, Children's Hospital Westmead and Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • John R Grigg
    Sydney Eye Hospital, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Peter J McCluskey
    Sydney Eye Hospital, Sydney, New South Wales, Australia
    Save Sight Institute, University of Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Sophia Zagora, None; Lawrence Oh, None; Chu L. Nguyen, None; Kevin Phan, None; Eugene Wong, None; Davinder Singh-Grewal, None; Jeffrey Chaitow, None; John Grigg, None; Peter McCluskey, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3526. doi:https://doi.org/
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      Sophia Zagora, Lawrence Oh, Chu L. Nguyen, Kevin Phan, Eugene Wong, Davinder Singh-Grewal, Jeffrey Chaitow, John R Grigg, Peter J McCluskey; Changing biological disease modifying treatment for paediatric uveitis in the real world. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3526. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Paediatric uveitis is a severe sight threatening uveitis due to disease progression and treatment failure. Traditionally corticosteroids and immunosuppressive agents are used to treat paediatric uveitis, often with poor outcomes. Biologic agents are a promising new treatment. This retrospective study provides real world data on their use from Sydney, Australia.

Methods : A retrospective, chart review over an 8-year period at a tertiary referral eye hospital of 27 paediatric uveitis patients treated with biologic agents was performed. Demographic data and treatment outcomes evaluating treatment efficacy: corticosteroid-sparing effect, topical steroid cessation/reduction, reduction in systemic-steroid sparing agents, change in intraocular inflammation, visual acuity and central macular thickness and treatment failure: adverse events was analysed. Data was collected at biologic initiation, 6 weeks, 6 months, and 12 months.

Results : Biologic therapy over 1 year was effective with prednisolone dose reduced to <5mg/day in 5 of 6 patients (83%), number ofsystemic steroid-sparing agents was reduced to ≤ 1 in 2/4 patients (50%), and cessation of topical steroid achieved in 12/41 of eyes (29%). Improvement of anterior chamber cells by 2 grades occurredin 20/25 eyes (80%), improvement of logMAR to ≤0.3occurredin 12/18 eyes (67%), and macular oedemadecreasedin 4/5 eyes (80%). Treatment failure occurred in 6 eyes (13.01%) and 5 patients (18.5%) developed an adverse reaction.

Conclusions : Biologic therapy was effective in paediatric patients with uveitis. Intraocular inflammation improved with maintained visual acuity, systemic corticosteroid dose decreased and there was a low frequency of adverse events

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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