Causes of uveitis in children without juvenile idiopathic arthritis

Figures & data

Table 1 Patient demographics, uveitis characteristics, clinical measures, and outcomes by site of ocular inflammation

	Anterior uveitis (n=24) (61.54%)	Intermediate uveitis (n=7) (17.95%)	Posterior uveitis (n=5) (12.82%)	Panuveitis (n=3) (7.69%)	All sites (n=39) (100%)
Sex (%)
Male	12 (50.00)	4 (57.14)	2 (40.00)	1 (33.33)	19 (48.72)
Female	12 (50.00)	3 (42.86)	3 (60.00)	2 (66.67)	20 (51.28)
Race/ethnicity (%)
Caucasian	12 (50.00)	3 (42.86)	3 (60.00)	2 (66.67)	20 (51.28)
African American	9 (37.50)	2 (28.57)	1 (20.00)	1 (33.33)	13 (33.33)
Hispanic	1 (4.17)	0 (0)	1 (20.00)	0 (0)	2 (5.13)
Other	2 (8.33)	2 (28.57)	0 (0)	0 (0)	4 (10.26)
Mean age (years) at diagnosis of uveitis (± SD)	11.0±4.62	12.9±3.97	13.7±3.07	13.0±5.68	11.90±4.39
Mean age (years) at presentation (± SD)	12.0±4.69	13.7±4.98	17.0±2.73	15.5±8.52	13.2±5.01
Mean duration (years) of follow-up (± SD)	3.76±6.84	2.69±4.38	0.96±1.19	2.53±2.22	3.11±5.72
Mean number of ophthalmology clinic visits (± SD)	11.71±12.03	8.14±5.24	10±10.44	6.0±2.65	10.41±10.36
Uveitis onset (%)
Acute	10 (41.67)	0 (0)	0 (0)	0 (0)	10 (25.64)
Chronic	7 (29.17)	5 (71.43)	3 (60.00)	2 (66.67)	17 (43.59)
Insidious	7 (29.17)	2 (28.57)	2 (40.00)	1 (33.33)	12 (30.77)
Uveitis laterality (%)
Bilateral	7 (29.17)	5 (71.43)	4 (80.00)	2 (66.67)	18 (46.15)
Unilateral	17 (70.83)	2 (28.57)	1 (20.00)	1 (33.33)	21 (53.85)
Initial logMAR BCVA (± SD)	0.451±0.713	0.592±0.870	0.295±0.329	0.476±0.511	0.458±0.680
Final logMAR BCVA (± SD)	0.518±0.960	0.313±0.491	0.226±0.345	0.366±0.493	0.411±0.760
Initial IOP (± SD)	14.69±5.95	11.83±3.46	15±2.92	16.6±1.14	14.27±4.85
Final IOP (± SD)	15.59±4.47	13.58±3.70	12±3.46	11.8±3.03	14.22±4.25

Abbreviations: BCVA, best-corrected visual acuity; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution; SD, standard deviation.

Table 2 Distribution of uveitis subtype

Anatomical localization	Number of patients (eyes)	Percentage of patients (eyes)
Anterior uveitis	24 (31)	61.53 (54.39)
Intermediate uveitis	7 (12)	17.95 (21.05)
Posterior uveitis	5 (9)	12.82 (15.79)
Panuveitis	3 (5)	7.69 (8.77)

Table 3 Diagnoses of pediatric uveitis

Diagnosis	Patients (n)	Patients (%)
Trauma	10	25.64
Anterior uveitis, undifferentiated	7	17.95
Intermediate uveitis, undifferentiated	6	15.38
Herpetic anterior uveitis	3	7.69
HLA-B27-associated anterior uveitis	3	7.69
Panuveitis, undifferentiated	2	5.13
TINU	2	5.13
Toxoplasmosis	1	2.56
Post-procedural	1	2.56
Sarcoidosis with collagen vascular disease	1	2.56
IRVAN	1	2.56
MEWDS	1	2.56
Posterior uveitis, undifferentiated	1	2.56
Total	39	100

Notes: HLA-B27-associated anterior uveitis designation includes psoriatic arthritis (n=1), ulcerative colitis (n=1), unspecified seronegative spondyloarthropathy.

Abbreviations: TINU, tubulointerstitial nephritis and uveitis syndrome; IRVAN, idiopathic retinitis, vasculitis, aneurysms, and neuroretinitis; MEWDS, multiple evanescent white dot syndrome.

Table 4 Management and interventions

Treatments and interventions	n (%)
Local steroids	26 (66.67)
Systemic steroids	9 (23.08)
Antimetabolites	8 (20.51)
Anti-TNF agents	1 (2.56)
Subtenon injection	3 (7.69)
Intravitreal injection	1 (2.56)
Glaucoma topical treatment	5 (12.82)
Glaucoma surgery	2 (5.13)
Cataract surgery	4 (10.26)
Pars plana vitrectomy	1 (2.56)

Abbreviation: TNF, tumor necrosis factor.

Table 5 Comparison of anatomical location and etiology of uveitis in studies of pediatric uveitis

References	Year	Location	n	Anterior uveitis	Intermediate uveitis	Posterior uveitis	Panuveitis	Undifferentiated	JIA	Toxoplasmosis
Current series	2015	VA, USA	39	54.39%	21.05%	15.79%	8.77%	41.03%	–	2.56%
Smith et al^Citation3	2009	MD, IL, OR, USA	527	44.60%	28%	14.40%	12.90%	29%	21%	5%
BenEzra et al^Citation2	2005	Jerusalem, Israel	276	13.40%	–	–	–	25.40%	14.90%	7.20%
Kump et al^Citation8	2005	Boston, MA, USA	269	56.88%	20.82%	6.32%	15.99%	51.67%	33%	3.35%
Azar and Martin^Citation14	2004	Sydney, Australia	40	66%	5.7%	13.2%	15.1%	60%	17.50%	2.50%
De Boer et al^Citation15	2003	Utrecht, the Netherlands	123	36%	24%	19%	21%	53.66%	20%	10%
Edelsten et al^Citation6	2003	London, UK	249	70%	–	30%	–	44%	47%	2%
Päivönsalo-Hietanen et al^Citation1	2000	Turku, Finland	55	90.90%	1.80%	5.50%	1.80%	47.30%	36.30%	5.50%
Tugal-Tutkun et al^Citation7	1996	Boston, MA, USA	130	58.40%	20%	13.80%	7.60%	36.80%	41.50%	7.70%

Note: Undifferentiated indicates idiopathic.

Abbreviation: JIA, juvenile idiopathic arthritis.

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