Childhood-onset uveitis: tertiary referral center experience in Tunisia

Author: Kmar Maaloul (Tunisia)

Co-authors: Salma Gargouri, Imen Kaibi, Sofien Affes, Sonda Kammoun, Imen Abid, Amira Trigui

Purpose

To describe the distribution, clinical findings, treatment, and complications of uveitis in children at a tertiary referral center in Sfax, Tunisia.

Setting/Venue

Department of Ophthalmology, Habib Bourguiba University Hospital, Sfax, Tunisia.

Methods

A retrospective study of 33 children (54 eyes) with uveitis examined at the Ophthalmology Department from January 2009 to December 2018. Data concerning clinical examination, etiological assessment and used treatments were collected. Standard diagnostic criteria were employed for all uveitic syndromes or entities.

Results

The mean age of the patients was 11.42 years with a male-to-female ratio of 0.74. Uveitis was bilateral in 63.3% of cases. The mean initial visual acuity was 3.2/10. The most common anatomical form was intermediate uveitis (39.4%). We found 51.5% of idiopathic uveitis, 24.2% of infectious uveitis, 15.2% of uveitis associated with a systemic disease, and 9.1% of uveitis associated with a specific ocular entity. The main complications were posterior synechiae (50%), papillary edema and/or atrophy (40.7%), cataract (24.1%) and cystoid macular edema (16.7%). Anti-infective treatment was prescribed in 24.2% of patients. Corticosteroid therapy was used locoregionally in 12.1% of cases and orally in 66.7%. Immunosuppressive therapy was initiated in 18.2% of patients and 6.1% received a biological agent. The mean final visual acuity was 4.6/10.

Conlusions

Pediatric uveitis is challenging to diagnose and manage, with frequent and vision-threatening complications. Most cases are idiopathic. Early and adequate diagnosis, rigorous ophthalmic and pediatric monitoring, and correct therapy are mandatory for good visual outcomes.

Financial Disclosure

No

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