Clinical Features of Pediatric Uveitis at a Tertiary Referral Center in the Western Region of Japan

ABSTRACT

Purpose

This study aimed to assess the clinical features of pediatric uveitis at a tertiary referral center in Western Japan.

Methods

One hundred forty eyes of 80 patients aged <20 years at the time of uveitis onset, who visited Kyushu University Hospital between January 2010 and December 2019 were included in this study. Clinical records were retrospectively reviewed. Demographics, clinical findings, treatments, and visual prognoses were compared between the disease groups.

Results

Of 80 patients, 32 were males and 48 were females. The average age of onset was 12.5 ± 4.8 (0–19) years. Tubulointerstitial nephritis and uveitis (TINU) and juvenile idiopathic arthritis (JIA) were the most frequent causes, accounting for 11.3% and 10% of cases, respectively, followed by sarcoidosis (5%), Behçet’s disease, acute anterior uveitis, Vogt-Koyanagi-Harada disease, and juvenile chronic iridocyclitis (3.8% each). Infectious uveitis accounted for 7.6% of the cases: cytomegalovirus was the most frequent agent. Of these cases, 43.8% were unclassified. Systemic therapies were administered to 87.5% of the patients with JIA, 33.3% of those with TINU, and 28.6% of the other diagnostic groups. In the unclassified group, 80% of the patients were followed up with only topical corticosteroids. LogMAR visual acuity of 0 or less accounted for more than 80% in the final examination.

Conclusion

TINU and JIA were the most common causes of pediatric uveitis. Although each required systemic therapy, most unclassified cases of pediatric uveitis were managed by topical corticosteroids alone with good visual prognosis. Accurate diagnosis is important for pediatric uveitis management.

KEYWORDS:

• Juvenile idiopathic arthritis
• pediatric uveitis
• systemic therapies
• tubulointerstitial nephritis and uveitis
• visual prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Patient consent

This study was approved by the Institutional Review Board of Kyushu University Hospital (Approval number: 21159–02) and conducted in accordance with the provisions of the Declaration of Helsinki. Informed consent was received from the patients by opt-out process.

Additional information

Funding

This work was supported by the Japan Society for the Promotion of Science (JSPS), grant numbers [21K09723]; the Japan Agency for Medical Research and Development (AMED), grant numbers [JP20jk0210029]; Kaketsuken research grant.