Risk Factors for Cystoid Macular Edema in Children with Uveitis
Purpose
CME is a major complication of non-infectious uveitis in children, often causing significant visual loss. The aim of this study was to identify risk factors for developing CME among pediatric uveitis patients.
Methods
This is a retrospective cohort study conducted in Israel and the UK and included 150 pediatric uveitis patients. Patients were excluded when sufficient data was unavailable. The cohort was divided into eyes that developed CME (group A) and those that did not (group B). Data retrieved included demographic information; age at presentation; type of uveitis based on the SUN classification and etiology; time to develop CME, complications at presentation and at periodic time points during follow up.
Results
Group A included 63 eyes of 36 patients and group B included 201 eyes of 114 patients. CME developed in the cohort at an estimated average time from onset of uveitis of 132±7.24 months (95% CI 118.13-146.5)
At time of diagnosis, 7.14% of eyes had band keratopathy present, 22.78% had posterior synechiae, 12.18% had cataract, 4.2% had glaucoma, and 8.33% already had CME. CME developed in 23.86% eyes (group A) on a mean time of 15.37±2.95 months. Multivariate analysis identified the following risk factors upon presentation for developing CME which included non-anterior uveitis HR 2.8, p<0.0001, BK HR 2.51 p<0.02, and PS HR 1.82 p=0.05. Cataract was significant in univariate analysis but lost significance when other factors were accounted for HR 1.51 p=0.29.
Conclusion
Pediatric uveitis patients presenting with non-anterior uveitis, band-K and posterior synechia had a greater risk of developing CME. Implementation of tight follow up schedule and aggressive treatment may be beneficial in such patients.
Conflict of interest
No
Author 1
Last name
BERLINER
Initials of first name(s)
O
Department
Department of Ophthalmology, Rabin Medical Cente
City
Petah Tikva
Country
Israel
Author 2
Last name
FRILLING
Initials of first name(s)
R
Department
Ophthalmology unit, Schneider Children’s Medical Cente
City
Petah Tikva
Country
Israel
Author 3
Last name
KSAB
Initials of first name(s)
A
Department
Institute of Ophthalmology, University College London, Moorfields Eye Hospital
City
London
Country
United Kingdom
Author 4
Last name
EIGER
Initials of first name(s)
M
Department
Department of Ophthalmology, Rabin Medical Center
City
Petah Tikva
Country
Israel
Author 5
Last name
NETZER
Initials of first name(s)
OT
Department
Department of Ophthalmology, Bnai Zion Medical Center
City
Haifa
Country
Israel
Author 6
Last name
KRAMER
Initials of first name(s)
M
Department
Department of Ophthalmology, Rabin Medical Center
City
Petah Tikva
Country
Israel
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