Bull Soc Belge Ophtalmol. 2001;(279):35-8.
Pediatric Ophthalmology and Immuno-Ophthalmology Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel. benezra@md2.huji.ac.il
AIM: To report on the causes of uveitis in children and young adults and their effects on visual functions. MATERIALS AND METHODS: Two hundred and seventy six patients, 18 years old or younger, with uveitis were included in this study. The intraocular inflammation (uveitis) was classified according to anatomical site of ocular involvement and the most probable etiological factor. The final diagnosis was based on clinical manifestations and the results of specific laboratory investigations. RESULTS: Bilateral intraocular inflammation was observed in 70.3% of the cases and 29.7% had either the left or the right eye involved. The symptomatology was relatively mild in most cases despite the fact that the visual acuity was markedly affected. An associated systemic disease was detected in 40.2% of the cases classified as non-infectious. Of this group, juvenile rheumatoid arthritis was the most common single systemic associated cause detected in 41 children. In 110 children (59.8%), the uveitis was strictly confined to the eyes with 70 of these (25.4% of the total group) classified as idiopathic. Parasites were the most common infectious-associated cause for the uveitis followed by viruses and bacteria. CONCLUSION: Uveitis is highly prevalent among children. In children, symptomatology of the intraocular inflammation may be very mild. However, visual acuity is markedly reduced leading to amblyopia in the young children. Early detection and treatment is therefore of utmost importance.
PMID: 11344713 [PubMed - indexed for MEDLINE]
Wednesday, January 31, 2007
Patterns of intraocular inflammation in children.
Patterns of uveitis in children presenting at a tertiary eye care centre in south India.
Indian J Ophthalmol. 2003 Jun;51(2):129-32.
Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India.
PURPOSE: To study the patterns of uveitis in the paediatric age group in a referral eye care centre in south India. MATERIALS AND METHODS: Thirty-one patients 15 years or younger with uveitis, examined in the year 2000, were included in this study. The uveitis was classified according to the anatomical site of ocular involvement and the most probable aetiological factor. The final diagnosis was based on clinical manifestations and results of specific laboratory investigations. RESULTS: A total 31 (6.29%) paediatric uveitis cases were seen among the 493 uveitic cases in the year 2000. The male:female ratio was 17:14. Anterior (9 cases), intermediate (9 cases) and posterior uveitis (9 cases) were seen in equal number. Four patients had panuveitis. Twenty-seven patients had visual acuity of 6/36 or better at presentation. Approximately 25% (8 of 31) patients had cataract secondary to inflammation. Immunosuppressives were administered in 4 patients and one patient required cataract surgery. CONCLUSION: Uveitis in children comprises approximately 6% of uveitis cases in a referral practice in south India. Anterior, intermediate and posterior uveitis are seen in equal numbers. We recommend that intermediate uveitis be ruled out in all cases of anterior uveitis by careful clinical evaluation including examination under anesthesia (EUA) when required.
PMID: 12831142 [PubMed - indexed for MEDLINE]
Pattern of uveitis in a referral eye clinic in north India.
Indian J Ophthalmol. 2004 Jun;52(2):121-5.
Department of Ophthalmology, Postgraduate Institute of Medical Eudcation and Research, Chandigarh, India.
PURPOSE: To report the pattern of uveitis in a north Indian tertiary eye center. METHODS: A retrospective study was done to identify the pattern of uveitis in a uveitis clinic population of a major referral center in north India from January 1996 to June 2001. A standard clinical protocol, the "naming and meshing" approach with tailored laboratory investigations, was used for the final diagnosis. RESULTS: 1233 patients were included in the study; 641 (51.98%) were males and 592 (48.01%) females ranging in age from 1.5 to 75 years. The anterior uveitis was seen in 607 patients (49.23%) followed by posterior uveitis (247 patients, 20.23 %), intermediate uveitis (198 patients, 16.06%) and panuveitis (181 patients, 14.68%). A specific diagnosis could be established in 602 patients (48.82%). The infective aetiology was seen in 179 patients, of which tuberculosis was the commonest cause in 125 patients followed by toxoplasmosis (21 patients, 11.7%). Non-infectious aetiology was seen in 423 patients, of which ankylosing spondylitis was the commonest cause in 80 patients followed by sepigionous choroidopathy (62 patients, 14.65%). CONCLUSION: Tuberculosis and toxoplasmosis were the commonest form of infective uveitis, while ankylosing spondylitis and serpiginous choroidopathy were commonly seen as the non-infective causes of uveitis in North India.
PMID: 15283216 [PubMed - indexed for MEDLINE]
Ocular complications of pediatric uveitis.
Ophthalmology. 2004 Dec;111(12):2299-306.
Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33101, USA.
PURPOSE: To determine the cumulative proportion and the visual significance of ocular complications of pediatric uveitis. DESIGN: Cohort study. PARTICIPANTS: Patients with onset of endogenous or infectious uveitis before or at age 16 years. METHODS: Retrospective review of existing records at a university-based uveitis clinic. MAIN OUTCOME MEASURES: Type and prevalence of complications related to uveitis, time to development of complications, and vision loss after initial diagnosis. RESULTS: There were 148 patients, 71 males and 77 females, with a mean age of 10.4+/-4.9 years (median, 10.3 years) for an estimated prevalence of pediatric uveitis of 13.8%. Noninfectious uveitis was present in 112 patients (75.7%); 105 (71%) patients had bilateral disease. Anterior uveitis accounted for 30.4%, intermediate uveitis for 27.7%, posterior uveitis for 23.7%, and panuveitis for 18.2% of patients. Patients were followed for a mean of 71.7 months (range, 0 months-44 years) after diagnosis. Approximately 34% of all patients had 1 or more complications at the time of first diagnosis of uveitis by an ophthalmologist, increasing to 61.6% by 3 months, 69.4% by 6 months, 75.2% by 1 year, and 86.3% by 3 years after diagnosis. There were a total of 617 complications of all types. Anterior and intermediate uveitis had a higher risk of band keratopathy (P = 0.005). Posterior and intermediate uveitis had a lower risk of cataract (P = 0.009) or posterior synechiae (P<0.001). p =" 0.002).">
PMID: 15582090 [PubMed - indexed for MEDLINE]
Analysis of pediatric uveitis cases at a tertiary referral center.
Ophthalmology. 2005 Jul;112(7):1287-92.
Ocular Immunology and Uveitis Foundation, Boston, Massachusetts, USA.
OBJECTIVE: To analyze demographics, anatomic data, diagnoses, systemic associations, and visual outcomes of pediatric patients in a large tertiary eye center. DESIGN: Retrospective cohort study. METHODS: The records of 1242 patients with uveitis referred to the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary (MEEI) from 1985 to 2003 were reviewed retrospectively. Two hundred sixty-nine patients 16 years and younger were identified. RESULTS: Among 269 children with uveitis, 53.5% were girls, 82% were Caucasian, and 82% were born in the United States. Mean age was 8 years (standard deviation, 3.8; range, 1-16). Anterior uveitis represented 56.9% of cases; intermediate, 20.8%; panuveitis, 16%; and posterior, 6.3%. Nongranulomatous (77.6%) and noninfectious (85.7%) were the most frequent types of inflammation. The process was bilateral in 74.4% of patients. Mean follow-up was 22 months, with mean age of 8 years at diagnosis. Mean duration of uveitis at the time of presentation at the MEEI was 2 years. The range of time between the diagnosis of uveitis and referral was 1 day to 5.6 years. The length of time between diagnosis of uveitis and the referral to the tertiary center strongly correlated with the complication rate and degree of visual impairment in our study. The longer the time before the patients were seen by the uveitis expert, the worse the visual outcomes. No systemic associations were found in 58% of patients, juvenile idiopathic arthritis was responsible for 33% of cases, 8% of patients had other systemic associations, and 1% had tubulointerstitial nephritis uveitis syndrome. CONCLUSIONS: Uveitis remains a serious cause of morbidity and visual loss in children. Timely referral to uveitis specialists in the tertiary referral centers may lead to improved visual outcomes in children with chronic uveitis.
PMID: 15921752 [PubMed - indexed for MEDLINE]
Friday, January 12, 2007
Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop.
Am J Ophthalmol. 2005 Sep;140(3):509-16.
Wilmer Eye Institute, 5650 North Broadway, Suite 700, Baltimore, MD 21205, USA. djabs@jhmi.edu
PURPOSE: To begin a process of standardizing the methods for reporting clinical data in the field of uveitis. DESIGN: Consensus workshop. METHODS: Members of an international working group were surveyed about diagnostic terminology, inflammation grading schema, and outcome measures, and the results used to develop a series of proposals to better standardize the use of these entities. Small groups employed nominal group techniques to achieve consensus on several of these issues. RESULTS: The group affirmed that an anatomic classification of uveitis should be used as a framework for subsequent work on diagnostic criteria for specific uveitic syndromes, and that the classification of uveitis entities should be on the basis of the location of the inflammation and not on the presence of structural complications. Issues regarding the use of the terms "intermediate uveitis," "pars planitis," "panuveitis," and descriptors of the onset and course of the uveitis were addressed. The following were adopted: standardized grading schema for anterior chamber cells, anterior chamber flare, and for vitreous haze; standardized methods of recording structural complications of uveitis; standardized definitions of outcomes, including "inactive" inflammation, "improvement'; and "worsening" of the inflammation, and "corticosteroid sparing," and standardized guidelines for reporting visual acuity outcomes. CONCLUSIONS: A process of standardizing the approach to reporting clinical data in uveitis research has begun, and several terms have been standardized.
PMID: 16196117 [PubMed - indexed for MEDLINE]