Physical and Psychosocial Health in Pediatric Uveitis Patients

Figures & data

Figure 1. Patient selection.

Table 1. Patient characteristics and outcome measurements compared to reference values.

	Number (%)	Mean (±SD)/Median (range)	Reference value	Z-score	Sig.
Age (yrs)		12.7 (± 2.7)
Female	13/23 (56.5%)
Anthropometrics
Height (cm)		156.7 (± 17.5)	AGD^Citation23	−0.19	p = .46
Weight (kg)		50.3 (± 17.7)	AGD^Citation23	0.58	p = .02
BMI		19.9 (± 4.0)	AGD^Citation23	0.67	p = .02
Underlying systemic disease
juvenile idiopathic arthritis (JIA)	10
PGA JIA activity	0 (0–10)
Uveitis^a
Idiopathic	13/23 (56.5%)
Time since diagnosis (yrs)		5.88 (1.28– 12.71)
Remission duration (yrs)^b		2.09 (0.17– 8.35)
Duration of active disease (yrs)		3.19 (0.55– 11.91)
Active disease (uveitis)	3 (13%)
Local medication	18
Steroids	8 (44.4%)
Anti-glaucoma	1 (5.6%)
Steroids and anti-glaucoma combined^c	9 (50%)
Systemic medication	14
MTX^d	7 (50%)
Biological (adalimumab)	1 (7.1%)
MTX and adalimumab combined	6 (42.9%)
Duration of systemic medication (mos)		54.4 (1.8– 112.4)
Physical fitness
VO2peak (l/min)		2.1 (± 0.84)	AGD^44	−0.40	p = .11
VO2peak/kg (l/min/kg)		41.3 (± 8.1)	AGD^44	−0.47	p = .07
Wpeak (Watt)		163 (± 65.5)	AGD^44	−0.49	p = .04
Wpeak/kg (Watt/kg)		3.3 (± 0.6)	AGD^44	−0.40	p = .05
HDD (Newton)		200.3 (± 68.2)	AGD^46	−0.58	p = .001
Questionnaires
Functional ability		0.22 (0– 1.44)	0.20^Citation51		p = .15
HR-QoL Child		84.2 (± 10.0)	83.91^Citation50,Citation51		p = .76
HR-QoL Parent		77.0 (± 11.7)	82.29		p = .04
Fatigue Child		82.9 (± 12.1)	80.49^Citation52		p = .25
Fatigue Parent		72.0 (± 18.0)	89.63		p < .001
Physical activity (N = 21)^e
Light physical activity (min)		182 (± 75)	256^Citation49		p < .001
MVPA (min)		36 (± 16)	54^Citation49		p < .001

SD = standard deviation, AGD = age and gender dependent, yrs = years, mos = months, min = minutes, BMI = body mass index, PGA = physician global assessment, MTX = methotrexate, VO_2peak = oxygen consumption at peak exercise, VO_2peak/kg = peak oxygen consumption per kg bodyweight, W_peak = peak work rate, W_peak/kg = peak work rate per kg bodyweight, HHD = hand held dynamometry, MVPA = moderate-to-vigorous physical activity, HR-QoL = health related quality of life. ^a See Table 2 for further specifications. ^b Remission on medication. ^c In 1 patient mydriatic eye drops were used as treatment next to steroid and anti-glaucoma eye drops^{. d} One patient used low dose (5 mg) systemic corticosteroids next to MTX. ^e In 2 patients the measurement of physical activity was invalid.

Table 2. Ocular features.

	Number of patients (N = 23)	Percentage	Median	Range
Uveitis localization
Anterior	15	65.2%
Intermediate	4	17.4%
Posterior	0	–
Panuveitis	4	17.4%
Bilateral disease	16	69.6%
Visual acuity (LogMAR*)
Worse eye			0.05	−0.08– 2.48
Better eye			0.00	−0.08– 0.22
Unilateral impairment**	2	8.7%
Unilateral blindness**	1	4.3%
Complications**	19	82.6%
Cataract	13	56.5%
Glaucoma	13	56.5%
Posterior synechiae	10	43.5%
Band keratopathy	5	21.7%
Amblyopia	1	4.3%
Surgery***	9	39.1%
Cataract extraction	8	34.8%
Baerveldt-implantation (anti-glaucoma treatment)	8	34.8%
Re-surgery	7	30.4%

LogMAR = Logarithm of the Minimum Angle of Resolution.

* A lower LogMAR visual acuity score corresponds to higher Snellen visual acuity and vice versa

** Visual impairment was defined as a visual acuity ≥ 0.05 (LogMAR ≤ 1.30) and < 0.3 (LogMAR > 0.50), blindness was defined as a visual acuity less than 0.01 (or LogMAR > 1.3) or a visual field ≤ 10º.³⁷

*** Because some patients had more than one complication, surgery or medication, the cumulative percentages

can be different from the total percentages.

Figure 2. Z-scores. The z-score represents the amount of standard deviations the value differs from the age and gender specific reference value. Values are presented as mean with 95% confidence interval.

Weight = weight for age, BMI = body mass index, Wpeak = peak work rate, Wpeak/kg = peak work rate per kg bodyweight, VO2peak = oxygen consumption at peak exercise, VO2peak/kg = oxygen consumption per kg bodyweight, Muscle strength = the sum of biceps, triceps, iliopsoas, and quadriceps muscles divided by eight as measured by hand-held dynamometry.

* Significant at p < .05 (see Table 1)

Table 3. Correlations.

	VO2peak*		HDD*		HR-QoL child		HR-QoL parent
	P	P	r	p	r	p	r	p
Gender	−0.15	0.51	−0.13	0.55	−0.25	0.25	−0.06	0.79
Age	0.37	0.09	0.51	0.01	0.40	0.06	0.30	0.17
Duration of active disease	−0.28	0.19	−0.12	0.59	−0.16	0.47	−0.63	0.001
systemic medication	−0.28	0.20	−0.05	0.81	−0.07	0.75	−0.21	0.33
Previous systemic CS	−0.20	0.37	0.17	0.43	−0.10	0.96	0.30	0.18
BMI*	0.30	0.17	0.69	< 0.001	0.38	0.08	−0.11	0.63
HDD*	0.53	0.01			0.55	0.01	0.19	0.38
VO2peak*			0.53	0.01	0.35	0.10	0.26	0.24
MVPA	0.05	0.85	−0.08	0.74	0.04	0.86	0.24	0.32
DI					−0.64	0.001	−0.10	0.64
HR-QoL child	0.35	0.10					0.06	0.78
HR-QoL parent	0.26	0.24			0.06	0.78
Fatigue child	0.36	0.09	0.46	0.03	0.83	< 0.001	−0.21	0.34
Fatigue parent	0.33	0.12	0.21	0.33	−0.04	0.85	0.73	< 0.001

Values presented as Spearman correlation (P) or Pearson correlation (r) and statistical significance (p). * Z-scores. Abbreviations: CS = corticosteroids, BMI = body mass index, HDD = hand-held dynamometry measurements for muscle strength, VO₂peak = peak oxygen consumption (l/min), MVPA = moderate-to-vigorous physical activity, DI = disability index, HR-QoL = health related quality of life.

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