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Clinical features of paediatric uveitis at a tertiary referral centre in São Paulo, SP, Brazil
  1. Fernanda Maria Silveira Souto1,
  2. Bárbara Vilela Giampietro1,
  3. Julia Thiemi Takiuti1,
  4. Lucia Maria Arruda Campos2,
  5. Carlos Eduardo Hirata1,
  6. Joyce Hisae Yamamoto1
  1. 1 Department of Ophthalmology, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
  2. 2 Pediatric Rheumatology Unit, Pediatric Department, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
  1. Correspondence to Fernanda Maria SilveiraSouto, Department of Ophthalmology, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246, Brazil; fernanda.souto{at}yahoo.com.br

Abstract

Aims To analyse the clinical features, systemic associations, treatment and visual outcomes of uveitis in children from a referral centre in São Paulo, Brazil.

Methods Clinical records of patients under 16 years old who attended the Uveitis Service, Hospital das Clinicas, Faculdadede Medicina, Universidade de São PauloFMUSP, between April and September 2017, were reviewed retrospectively. Patients with incomplete medical records, previous ocular trauma, or less than six6 months of follow-up were excluded.

Results Thirty-nine children (25 female/14 male) were included. There was predominance of bilateral (89.7%), asymptomatic (56.4%) and recurrent/chronic cases (84.6%). The mean age at study inclusion was 10.7±3.4 years (range 3–16 years). Improvement or preservation of visual acuity (VA) was observed in 27 patients (84%); VA was not informed in 8 patients. Patients were referred early to tertiary centre (55% within 6 months of uveitis diagnosis). Anterior uveitis was the most common involvement (46%), followed by intermediate uveitis (26%). Juvenile idiopathic arthritis (JIA)-associated uveitis (41%) and immune-mediated intermediate uveitis (25.6%) were the principal non-infectious conditions; ocular toxoplasmosis (7.7%) and toxocariasis (5.1%) were the most common infectious conditions. Ocular complications were observed at first visit in 46% of patients and in 90% during final evaluation. Oral prednisone, immunosuppressive therapy (IMT) and/or biologic agents were used in all non-infectious conditions (32 children, 82%); IMT and/or biologic agents were used in all patients with JIA-associated uveitis and in 50% of patients with immune-mediated intermediate uveitis.

Conclusion Paediatric patients with uveitis are referred early to this centre and, although severe, adequate management with systemic IMT may preserve VA.

  • inflammation
  • child heath (paediatrics)
  • treatment medical

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Footnotes

  • Contributors Definition of study design: JHY. Data collection: FMSS, BVG, JTT. Analysis and interpretation of data: JHY, FMSS, BVG, JTT, LMAC, CEH. Manuscript writing: JHY, FMSS, BVG, JTT, LMAC, CEH. Critical review and approval of the manuscript: JHY, FMSS, BVG, JTT, LMAC, CEH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Ethics Commission for Analysis of Research Projects (CapPesq 2.289.047).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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