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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.13.05 Epidemiology and course of pediatric uveitis in regard to severity of complications and immunosuppressive therapy Enzmann M. S.1,2, Grulich-Henn J.1,3, Becker M. D.1,2, Mackensen F.1,2
1Interdisciplinary Uveitis Center, 2University Eye Hospital, 3University Children's Hospital, Heidelberg Objective: Patients up to 18 years of age only account for about 10% of patients with uveitis. However, they seem to experience a more severe course of disease. The objective of our study was the retrospective analysis of our patients in order to gain better understanding of etiology and prognosis.
Methods: Patients with onset of disease before the age of 19 years were included from the Heidelberg uveitis database. Patient demographics, type, course, complications, visual acuity, operations and treatment were recorded to previously determined timepoints.
Results: 186 patients were included, 88 males, 98 females. The age median was 15 years (1-28). Anterior uveitis was recorded in 52% of patients, 25% primary forms and 70% secondary (mainly due to juvenile idiopathic arthritis). Intermediate uveitis accounted for 26% out of which 65% were primary and 19% secondary. Posterior uveitis accounted for 19%, 9% primary and 82% secondary. 3% of patients had panuveitis. 166 children received diverse, sometimes combined medications: local corticosteroids (n=49), systemic corticosteroids (n=111), non-steroidal antiphlogistics (n=27), methotrexate (n=52), azathioprine (n=20), mycophenolatmofetil (n=8), ciclosporine (n=17), etanercept (n=4), cyclophosphamide (n=2), tacrolimus (n=1), sulfasalazine (n=3), immunoglobulin i.v. (n=1) and other systemic non-immunosupressive therapies (n=40). 18% of the patients were operated: cataract (n=21), glaucoma (n=5), cornea (n=3), posterior segment (n=20), others (n=6). Visual acuity less than 0,1 was recorded in 13% of patients at first visit, 10% of patients at 1-year follow-up, 12% of patients at 3-year follow-up, and 34% of patients at 5-year follow-up.
Conclusions: Pediatric uveitis needs special attention on account of frequent complications and difficult therapy. Interdisciplinary cooperation is an ideal setting for this. Our studies seem to affirm that a longer course of disease results in worse vision. However, the small number of patients in the 5 year cohort and the negative selection of patients followed in a specialised center have to be considered.
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