Longitudinal Vision Outcomes after Cataract Extraction in Pediatric Uveitis
Purpose
We evaluated visual outcomes in a pediatric uveitis cohort on systemic therapy undergoing cataract surgery.
Methods
Retrospective cohort of uveitis patients <18 years over 13 years. Data collection: demographics, treatment, visual acuity (VA) and postoperative complications. Descriptive statistics were calculated. VA was examined over time using a repeated measures means model. Tests were two-sided using alpha 0.05 using SAS v9.
Results
258 patients with uveitis. Mean age 11.1 (+/- 4.3 years); 54% female; 65% with bilateral disease. Anterior uveitis was most common location (65%) and Juvenile Idiopathic Arthritis (JIA) was most common diagnosis (25%). Methotrexate (93%) most frequently used antimetabolite (48%). Adalimumab (68%) most frequently used anti-TNF (31%). Treatment failure was main reason (74%) to add anti-TNF.
65 eyes underwent cataract surgery: mean age 10.8 years (range 4-17). 31% on antimetabolites; 29% on anti-TNF, most commonly infliximab (68%); 40% on no treatment. VA improved in all eyes but better in anti-TNF (p = 0.002). Intraocular pressure increased in all eyes (p=0.0069) but higher on anti-TNF (p=0.0128).
Conclusion
In this first report of outcomes after cataract surgery on systemic therapy, Infliximab was used more frequently than adalimumab in those undergoing surgery. Cataract surgery improved vision in all eyes. Despite younger age, patients on anti-TNF had better long-term vision but higher IOP.
Conflict of interest
No
Authors 1
Last name
O'KEEFE
Initials of first name(s)
G
Department
Ophthalmology
City
Atlanta
Country
United States
Authors 2
Last name
Devaro
Initials of first name(s)
S
Department
Emory University School of Medicine
City
Atlanta
Country
United States
Authors 3
Last name
Hojjatie
Initials of first name(s)
S
Department
Ophthalmology
City
Seattle
Country
United States
Authors 4
Last name
Ward
Initials of first name(s)
L
Department
Public Health
City
Atlanta
Country
United States
Authors 5
Last name
Lenhart
Initials of first name(s)
P
Department
Ophthalmology
City
Atlanta
Country
United States
Authors 6
Last name
Shantha
Initials of first name(s)
J
Department
Ophthalmology
City
Atlanta
Country
United States
Authors 7
Last name
O'Keefe
Initials of first name(s)
G
Department
Ophthalmology
City
Atlanta
Country
United States
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