Abstract
Purpose :
To analyse clinical features, systemic associations, treatment, and visual outcomes of pediatric patients with ocular inflammation at a tertiary center in western Tokyo, Nippon Medical School Tama Nagayama Hospital (NMS-TN).
Methods :
We retrospectively studied the medical records of 621 patients with ocular inflammation of all ages who presented to the Ocular Inflammation Service at NMS-TN from April 2018 to March 2023. Then, 25 cases 42 eyes were selected on the basis of age 19 or younger at the time of their first visit.
Results :
Of the 621 patients with ocular inflammation of all ages, 25 (4%) were children. The age at the first presentation was 14.0 ± 2.7 years (7-19 years), with eight boys and 17 girls. Seventeen cases were bilateral. The most common reason for their hospital visit was hyperemia (15 cases, 60%). The most frequent diagnoses were Tubulointerstitial nephritis and uveitis syndrome (TINU) (8 cases, 32%), scleritis (5 cases, 20%), and Behcet's disease (2 cases, 8%), followed by geographic choroiditis and Posner-Schlossman syndrome. 28.0% of the cases were unclassifiable. Pan-uveitis was the most common site of inflammation, accounting for 16 cases. The most common ocular findings at the first visit were keratic precipitates and retinal vasculitis in 15 patients (60%) each. The percentage of eyes with a visual acuity of 1.0 or better was 73% at the first visit and 95.2% at the last visit (22 months on average). Inflammatory choroidal neovascularization developed in 3 patients (12%). Secondary glaucoma was observed in 13 patients (52.0%) and steroid glaucoma in 6 patients (24.0%). All patients were treated with steroid eye drops, and systemic treatments included celecoxib in 11 cases, oral steroids in 6 patients, steroid pulse therapy in 3 cases, and biologic agents and immunosuppressants in 2 patients. Intravitreal injections of VEGF inhibitors were used for inflammatory choroidal neovascularization.
Conclusions :
In this study, the majority of pediatric patients were girls, bilateral, and had good visual acuity, and TINU and scleritis were common. 24.0% of the patients required systemic steroids or immunosuppressive therapy, and most eyes had a good visual outcome. About half of the patients had secondary glaucoma.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.