Ocular complications in children with idiopathic chronic anterior uveitis
Purpose
To describe the course and development of ocular complications in children with idiopathic chronic anterior uveitis (CAU).
Methods
Data of 48 patients (83 affected eyes) with idiopathic CAU were collected retrospectively. Outcome measures were: visual acuity, systemic treatment, ocular complications and surgery. Outcomes of children with a younger (≤8 years) and older onset of uveitis (>8 years) were compared using Cox proportional hazard analysis with correction for paired eyes.
Results
Median age of onset of uveitis was 7.8 years (range 3.3-16). Bilateral disease was present in 35 patients (73%). Fifteen patients (31%) were treated with systemic corticosteroids. Thirty-six patients (75%) were treated with immunomodulatory therapy, of whom 29% (n=14) were treated with an additional biological agent. Complications were present in 43% of the affected eyes at onset of uveitis and increased to 74% at 5 years of follow-up. At 5 years of follow-up the younger age group suffered more frequently from posterior synechiae (HR 2.6, p<0.01) and secondary glaucoma (HR 16, p=0.02), and needed more cataract surgery (HR 4.8, p<0.01). Visual acuity was significantly worse in the younger age group (0.15 vs 0.00 logMAR, p<0.001), but improved at 5 years of follow-up (0.05 vs 0.00 logMAR, p=0.82).
Conclusion
Vision-threatening ocular complications occur in the majority of the children with idiopathic CAU. They are more common in children with a younger age of onset of uveitis and are frequently being present at onset. Nevertheless, long-term vision usually stays good.
Conflict of interest
No
Authors 1
Last name
KOUWENBERG
Initials of first name(s)
CV
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 2
Last name
Shahabi
Initials of first name(s)
M
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 3
Last name
de Boer
Initials of first name(s)
JH
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 4
Last name
Koopman-Kalinina Ayuso
Initials of first name(s)
V
Department
Ophthalmology
City
Utrecht
Country
Netherlands
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