DEC 04, 2009
Pediatric Ophth/Strabismus, Uveitis
This study's authors report the results of a retrospective longitudinal cohort study involving 527 children diagnosed with uveitis and evaluated and treated at three U.S. tertiary care centers: the National Eye Institute, the University of Illinois at Chicago and Oregon Health Sciences University. The study describes demographic and clinical characteristics of uveitis patients, treatments, ocular complications and visual outcomes. The leading diagnoses associated with pediatric uveitis were indeterminate cause (idiopathic) in 29 percent of patients, juvenile idiopathic arthritis-associated uveitis in 21 percent and pars planitis in 17 percent. Cumulative incidences of ocular complications and visual loss were reported at one, three, five, and 10 years of follow-up.
The prevalence of legal blindness at baseline was 9 percent and ranged from 3 to 15 percent during the 10-year follow-up period. Children with posterior uveitis or infectious uveitis had higher prevalences of poor vision at baseline. Ocular complications occurred frequently, and macular edema and hypotony were significantly associated with poor visual outcomes.
This paper's strengths include the regional and ethnic diversity of the cohort and the use of standardized grading and reporting criteria that allowed for comparability between the three clinical centers. Its potential weaknesses include its retrospective nature and lack of standardized follow-up. All centers provided tertiary care, so more severe uveitic disease may be overrepresented relative to the broader spectrum of pediatric uveitis that includes cases treated in the community practice setting.
This longitudinal data may be particularly helpful to uveitis specialists in referral-based practices who treat and follow children with the condition.
Dr. Thorne receives grant support from Research to Prevent Blindness.