Clinical Characteristics And Visual Prognosis Of Children With Uveitis

Objective:To analyze demographics, causes, features, and predictors of visual outcomes of pediatric uveitis.Methods:This retrospective study included patients with uveitis under 16 years old, they visited the Peking Union Medical College Hospital from December 1999 to December 2014. The classifications and causes of uveitis were identified based on the history and clinical examination, the uveitis characteristics, complications, therapeutic effects, surgical procedures and predictors of visual outcomes were analysed.Results:A total of 107 cases(182 eyes) with pediatric uveitis were included in this study, 42.1% were boys and 57.9% were girls, the male to female ratio was 1:1.38. The process was bilateral in 70% of the patients. The mean age at onset of uveitis was 8.2±3.3 years old and the mean follow-up was 1.25(0.4,2)year. The identifiable leading cause was juvenile idiopathic arthritis(12.1%) and the most common anatomical classifications were panuveitis(49.6%) and anterior uvetis(43.9%). Among the 107 cases of patients, insidious onset occurred in 53 cases(49.5%), the courses were persistent in 65 cases(60.7%). Ocular complications occurred in 85.2% of all affected eyes, of which the most common were cataract, steroid induced ocular hypertension and posterior synechiae.73 patients (68.2%) needed systemic medication treatment, except for the epiretinal membrane, the incidence of other ocular complications and visual impairment were higher in patients who needed oral glucocorticoid or immunosuppressant(All OR>1, P<0.05), patients who needed a combined therapy had greater chances of developing visual impairment(OR=3.74, P=0.009).45(24.7%) affected eyes had a final BCVA less than 0.4 and 25(13.7%) affected eyes had a final BCVA less than 0.1. Insidious onset, persistent duration, previous BCVA ≤0.4 and the presence of posterior synechiae were associated with a final BCVA less than 0.4(All P<0.05).Conclusions:Pediatric uveitis is a possible blindness disease with varieties of etiology, insidious onset and persistent duration are very common in pediatric uveitis. Panuveitis and anterior uveitis are predominant. Pediatric uveitis tends to be easily affected by various ocular complication. More than half of the patients need systemic medication treatment, the incidence of ocular complications and visual impairment are higher in patients who need systemic medication treatment. Insidious onset, persistent duration, previous BCVA≤0.4 and the presence of posterior synechiae are associated with visual impairment. The complications of pediatric uveitis are the main cause of blindness.