gms | German Medical Science

Uveitis in childhood frequently leads to visual deterioration. We analysed the epidemiologic data and the vision-threatening complications in different forms of uveitis of childhood.

Retrospective study of 187 consecutive uveitis patients (n= 85 girls, n= 102 boys) with onset of disease before the age of 16 years. 108 patients had anterior-, 54 intermediate-, 11 posterior uveitis and 14 patients had panuveitis. We analysed the epidemiologic data as well as visual acuity, uveitic complications and the conservative- and surgical therapy.

Systemic disease was observed in 85 of 187 patients, with juvenile idiopathic arthritis (JIA) being the most frequent entity: 52.8% of patients with anterior uveitis had JIA. Most of the patients with intermediate uveitis (n=49) had no systemic disease association. Toxoplasmosis or toxocariasis chorioretinitis was diagnosed in 6 of the 11 patients with posterior uveitis; another 4 with panuveitis suffered from sarcoidosis. The most common complications in anterior uveitis patients were cataract (n=51), posterior synechiae (n=53), band keratopathy (n=40) and CME (n=15). Patients with juvenile idiopathic arthritis had more complications than other patients with anterior uveitis. Intermediate uveitis was accompanied by dense vitreous opacities (n=39), cataract (n=19) and CME (n=9). Macular scars were the reason for visual loss in 7 of the 11 patients with posterior uveitis. Patients with panuveitis developed complications as dense vitreous opacities (n=8), cataract (n=7), retinal detachment (n=4), CME (n=4) and phthisis bulbi (n=2). Complications were especially common in patients with early onset sarcoidosis and uveitis. The systemic medical treatment required included glucocorticoids (n= 114), methotrexate (n=59), cyclosporine A (n=12), azathioprine (n=16), MMF (n=1) and biologicals (n=2). 39 patients underwent cataract surgery, 38 patients vitrectomy, and 10 patients needed glaucoma surgery. 26 patients (n=29 eyes) had visual acuity of 0.1 or less at final examination, and 2 eyes were blind.

Uveitis in childhood frequently is followed by complications that cause visual deterioration. Early diagnosis of uveitis and its vision-threatening complications is mandatory. The high rate of complications points out the need for a frequent use of immunosuppression and operations.