Clinical Course and Outcome in Pediatric Idiopathic Chronic Anterior Uveitis

Abstract

PURPOSE: To examine the clinical course and outcome in children with idiopathic chronic anterior uveitis (iCAU), and to compare the results with those of age-matched children with juvenile idiopathic arthritis−associated uveitis (JIA-U). DESIGN: Retrospective cohort study. METHODS: Data regarding ocular complications, visual acuity, and systemic treatment were retrospectively collected for 2 patient groups that were matched regarding age and year of uveitis diagnosis. Outcome was evaluated using survival analysis. RESULTS: The iCAU and JIA-U groups included 48 patients with 83 affected eyes and 48 patients with 73 affected eyes, respectively. Multivariate analyses showed that iCAU was associated with a higher prevalence of posterior synechiae (adjusted hazard rate [aHR] = 3.63; P <.001) and cataract surgery (aHR = 2.90; P =.006). Baseline visual acuity was worse in the iCAU group compared to the JIA-U group (20/25 vs 20/20, respectively; P <.001), but improved in the iCAU group after 5 years (20/20 vs 20/20, respectively; P =.052). At the 5-year follow-up, the younger children with iCAU (≤8 years of age at diagnosis) had a higher prevalence of posterior synechiae (aHR = 2.56; P =.007), secondary glaucoma (aHR = 16.0; P =.020), and cataract surgery (aHR = 4.79; P =.004) compared to older children with iCAU (≥9 years at diagnosis). CONCLUSIONS: Vision-threatening ocular complications are more common in children with iCAU compared to children with JIA-U, particularly in cases in which the onset of uveitis occurred at ≤8 years of age. However, the long-term vision of these children can be improved with adequate treatment.