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Journal Francais D'ophtalmologie Feb 2023The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
PURPOSE
The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
METHODS
We performed a retrospective study of all cases of all pediatric uveitis seen at our institution over a 7-year period.
RESULTS
A total of 141 eyes of 86 children were included. The mean age was 10.7 years, and 61.6% were girls. The uveitis was bilateral in 64.0% of cases. Anterior uveitis (41.0%) and intermediate uveitis (32.0%) were the most frequent forms. The most frequent etiologies were idiopathic (27.9%), juvenile idiopathic arthritis (25.6%) and pars planitis (18.6%). During the follow-up period, systemic corticosteroids were received by 43.0% of children, immunosuppressive drugs by 31.4% and biological agents by 18.6%. At the final examination, complications were present in 67.0% of patients: 18.0% had cataracts, and 11.3% had intraocular hypertension. Posterior synechiae were present in 27.6% of eyes, optic disc edema in 10.5% and macular edema in 16.2%. At the last visit, visual acuity was better than 20/200 in 97.0% of cases. The presence of band keratopathy, cataract or glaucoma was an independent predictor of impaired visual outcomes at follow-up.
CONCLUSION
Juvenile idiopathic arthritis is one of the most frequent and severe pediatric uveitides. Close monitoring and early treatment could prevent complications.
Topics: Female; Child; Humans; Male; Prognosis; Arthritis, Juvenile; Retrospective Studies; Uveitis; Uveitis, Anterior; Cataract
PubMed: 36642594
DOI: 10.1016/j.jfo.2022.08.005 -
Ocular Immunology and Inflammation Dec 2023To report the causes of childhood-onset uveitis in a tertiary pediatric ophthalmology hospital in Egypt.
PURPOSE
To report the causes of childhood-onset uveitis in a tertiary pediatric ophthalmology hospital in Egypt.
METHODS
Retrospective study of the medical records of all uveitis patients following up at a tertiary pediatric ophthalmology hospital in Egypt from January 2017 to December 2020.
RESULTS
The present study included 388 patients. The most common anatomical category was intermediate uveitis (30.4%), and around half of these children had pars planitis. This was followed by panuveitis (25.5%), posterior uveitis (23.5%), and anterior uveitis (20.6%), in decreasing frequency. Juvenile idiopathic arthritis, toxoplasmosis, and Vogt-Koyanagi-Harada syndrome were the most common causes of anterior uveitis, posterior uveitis, and panuveitis respectively. Cataract (40.5%), glaucoma (33.8%), and cystoid macular edema (31.6%) were the most frequent ocular complications.
CONCLUSION
The present report provides the relative prevalence of the different anatomical types of uveitis, as well as their main causes in a cohort of Egyptian patients with childhood-onset uveitis.
Topics: Humans; Child; Egypt; Retrospective Studies; Uveitis; Panuveitis; Uveitis, Posterior; Tertiary Care Centers; Uveitis, Anterior; Acute Disease
PubMed: 36094930
DOI: 10.1080/09273948.2022.2117201 -
Ocular Immunology and Inflammation Dec 2023To report demographic and clinical profiles of children with uveitis in theTurkishpopulation.
PURPOSE
To report demographic and clinical profiles of children with uveitis in theTurkishpopulation.
METHODS
The data of the pediatric uveitis cases in the nation wide uveitis database were analyzed.
RESULTS
The study included 697 eyes of 442 patients with a meanage of 10.8 ± 3.8 years. There were 333 patients (75.3%) with non-infectious uveitis and 69 patients (15.6%) with infectious uveitis. Pars planitis (20.1%) was leading clinical form followed by idiopathic cases with uveitis other than pars planitis (18.8%), juvenile idiopathic arthritis(JIA) related uveitis (12.4%), Behçet uveitis (9.3%) and toxoplasma retinochoroiditis (7.9%). Ocular involvement was unilateral in 187 patients (42.3%) and bilateral in 255 patients (57.7%). The most common anatomiclocation of uveitis was anterior uveitis (39.1%), followed by intermediate uveitis (29.4%), panuveitis (16.1%) and posterior uveitis (15.4%).
CONCLUSION
The most common systemic association was JIA in the younger children and Behçet disease in the older children.
Topics: Child; Humans; Adolescent; Pars Planitis; Turkey; Retrospective Studies; Uveitis; Behcet Syndrome; Arthritis, Juvenile; Registries
PubMed: 36083691
DOI: 10.1080/09273948.2022.2110900 -
International Ophthalmology Jan 2023To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs)...
AIM
To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs) in the treatment of pars planitis (PP).
METHODS
The patients with PP who were treated with anti-TNF-alpha agents for at least six months were qualified for the chart review. The outcome parameters were the steroid-free remission state, the best-corrected visual acuity (BCVA) and the central macular thickness (CMT) of the patients at the last visit.
RESULTS
After a mean total follow-up time of 15.5 ± 5.8 months (8-24 months), all the cases were in steroid-free remission at the last visit. The mean BCVA increased, and the mean CMT decreased significantly at the last visit (p < 0.001, p < 0.001, respectively).
CONCLUSION
ADA combined with IMAs offers effective and safe treatment modalities in the control of chronic intraocular inflammation in PP cases.
Topics: Child; Humans; Adalimumab; Inflammation; Necrosis; Pars Planitis; Retrospective Studies; Treatment Outcome; Tumor Necrosis Factor Inhibitors; Turkey
PubMed: 35780435
DOI: 10.1007/s10792-022-02398-z -
Ocular Immunology and Inflammation Jul 2023This review aims to provide an update on the clinical presentation, etiologies, complications, and treatment options in intermediate uveitis (IU). (Review)
Review
PURPOSE
This review aims to provide an update on the clinical presentation, etiologies, complications, and treatment options in intermediate uveitis (IU).
METHODS
Narrative literature review.
RESULTS
IU affects all age groups with no clear gender predominance and has varied etiologies including systemic illnesses and infectious diseases, or pars planitis. In some instances, IU may be the sole presentation of an underlying associated condition or disease. Management of IU and its complications include administration of corticosteroids, antimetabolites, T-cell inhibitors, and/or biologics, along with surgical interventions, with varying degrees of effectiveness across literature. In particular, increasing evidence of the safety and efficacy of immunomodulatory agents and biologics has seen greater adoption of these therapies in clinical practice.
CONCLUSIONS
IU is an anatomical description of uveitis, involving intraocular inflammation of the vitreous, peripheral retinal vasculature, and pars plana. Various treatment options for intermediate uveitis are currently used in practice.
Topics: Humans; Uveitis, Intermediate; Pars Planitis; Uveitis; Vision Disorders; T-Lymphocytes
PubMed: 35759636
DOI: 10.1080/09273948.2022.2070503 -
Ophthalmology. Retina Nov 2022To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current...
PURPOSE
To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow.
DESIGN
Retrospective, observational case series.
PARTICIPANTS
Eyes presenting with fernlike patterns of dye leakage on UWFA were included in this study.
METHODS
Analysis of the clinical characteristics and multimodal imaging findings using UWFA and wide-angle swept-source OCT-angiography (SS-OCTA).
MAIN OUTCOME MEASURES
The disease spectrum, anatomic origin, and clinical implications of this fernlike leakage.
RESULTS
Multimodal retinal images from 40 eyes of 29 patients with fernlike leakage on UWFA were studied. The underlying etiologies included a wide range of inflammatory disorders, including pars planitis (18 eyes) and central retinal vein occlusion (2 eyes). On UWFA, the fernlike leakage originated from the retinal capillaries and venules directly adjacent to the veins and spared the periarterial zone. This perivenular fernlike leakage involved the far periphery in all cases and progressed more diffusely and centripetally in cases with more severe intraocular inflammation. On wide-angle SS-OCTA, the impairment of deep capillary plexus (DCP) flow signals precisely colocalized with the perivenular fernlike leakages identified on UWFA.
CONCLUSIONS
The fernlike leakage on UWFA refers to the distinctive perivenular dye leakage that originates from the retinal capillaries and venules. Multimodal imaging correlation suggests that the predominant impairment is at the level of the DCP. The axial symmetry of the fernlike leakage with the veins and sparing of the periarterial zone may support the dominant venous role of the DCP.
Topics: Humans; Fluorescein Angiography; Retrospective Studies; Tomography, Optical Coherence; Retinal Vein Occlusion; Retinal Vein
PubMed: 35545196
DOI: 10.1016/j.oret.2022.05.001 -
Graefe's Archive For Clinical and... Jun 2022
Topics: Adalimumab; Humans; Multiple Sclerosis; Pars Planitis; Uveitis, Intermediate
PubMed: 35088114
DOI: 10.1007/s00417-021-05528-y -
Graefe's Archive For Clinical and... Jun 2022
Topics: Adalimumab; Humans; Multiple Sclerosis; Pars Planitis; Uveitis, Intermediate
PubMed: 35015113
DOI: 10.1007/s00417-021-05527-z -
Journal of Clinical Medicine Dec 2021Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other...
Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18-83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet's disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1-30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.
PubMed: 34945256
DOI: 10.3390/jcm10245960 -
Therapeutic Advances in Ophthalmology 2021Pediatric uveitis accounts for up to 10% of all uveitis cases, so special attention must be paid to ensure early diagnosis as well as treatment and follow-up of these... (Review)
Review
Pediatric uveitis accounts for up to 10% of all uveitis cases, so special attention must be paid to ensure early diagnosis as well as treatment and follow-up of these young patients in order to decrease the risk of possible ocular complications and consequently vision loss. Multimodal imaging has been an effective and important adjunct in the diagnoses and management of uveitis, especially in children. Reviewed here are the currently utilized modalities, advances, as well as their applications in juvenile idiopathic arthritis-associated uveitis, pars planitis, retinal vasculitis, tubulointerstitial nephritis and uveitis syndrome, Behçet disease, Blau syndrome, and Vogt-Koyanagi-Harada syndrome.
PubMed: 34901748
DOI: 10.1177/25158414211059244