Clinical features of paediatric uveitis at a tertiary referral centre in Sao Paulo, SP, Brazil

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11
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article
Data de publicação
2019
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BMJ PUBLISHING GROUP
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BRITISH JOURNAL OF OPHTHALMOLOGY, v.103, n.5, p.636-640, 2019
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Aims To analyse the clinical features, systemic associations, treatment and visual outcomes of uveitis in children from a referral centre in Sao Paulo, Brazil. Methods Clinical records of patients under 16 years old who attended the Uveitis Service, Hospital das Clinicas, Faculdadede Medicina, Universidade de Sao 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.
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Referências
  1. Ayuso VK, 2011, AM J OPHTHALMOL, V151, P217, DOI 10.1016/j.ajo.2010.08.021
  2. BenEzra D, 2005, BRIT J OPHTHALMOL, V89, P444, DOI 10.1136/bjo.2004.050609
  3. Biester S, 2007, BRIT J OPHTHALMOL, V91, P319, DOI 10.1136/bjo.2006.103721
  4. Cunningham ET, 2016, OCUL IMMUNOL INFLAMM, V24, P365, DOI 10.1080/09273948.2016.1204777
  5. de Boer J, 2003, BRIT J OPHTHALMOL, V87, P879, DOI 10.1136/bjo.87.7.879
  6. Edelsten C, 2003, AM J OPHTHALMOL, V135, P676, DOI 10.1016/S0002-9394(02)02148-7
  7. Fernandez DG, 2017, OCUL IMMUNOL INFLAMM, V25, P382, DOI 10.3109/09273948.2015.1132741
  8. Ganesh SK, 2016, OCUL IMMUNOL INFLAMM, V24, P402, DOI 10.3109/09273948.2015.1012298
  9. Gouveia Enéias Bezerra, 2004, Arq. Bras. Oftalmol., V67, P139, DOI 10.1590/S0004-27492004000100025
  10. Hawkins MJ, 2016, SURV OPHTHALMOL, V61, P197, DOI 10.1016/j.survophthal.2015.10.005
  11. Holland GN, 2003, AM J OPHTHALMOL, V135, P867, DOI 10.1016/S0002-9394(03)00314-3
  12. Jabs DA, 2000, AM J OPHTHALMOL, V130, P492, DOI 10.1016/S0002-9394(00)00659-0
  13. Jabs DA, 2005, AM J OPHTHALMOL, V140, P509, DOI 10.1016/j.ajo.2005.03.057
  14. Keino H, 2017, BRIT J OPHTHALMOL, V101, P406, DOI 10.1136/bjophthalmol-2015-308194
  15. Khairallah M, 2006, OCUL IMMUNOL INFLAMM, V14, P225, DOI 10.1080/09273940600732372
  16. Kump LI, 2005, OPHTHALMOLOGY, V112, P1287, DOI 10.1016/j.ophtha.2005.01.044
  17. Lonngi M, 2016, OCUL IMMUNOL INFLAMM, V24, P410, DOI 10.3109/09273948.2016.1160129
  18. Majumder Parthopratim Dutta, 2013, Oman J Ophthalmol, V6, P140, DOI 10.4103/0974-620X.122267
  19. Nagpal Agnieszka, 2008, Int Ophthalmol Clin, V48, P1, DOI 10.1097/IIO.0b013e31817d740e
  20. Roberto Adriana M., 2002, J. Pediatr. (Rio J.), V78, P62, DOI 10.1590/S0021-75572002000100013
  21. Rosenberg KD, 2004, OPHTHALMOLOGY, V111, P2299, DOI 10.1016/j.ophtha.2004.06.014
  22. Smith JA, 2009, OPHTHALMOLOGY, V116, P1544, DOI 10.1016/j.ophtha.2009.05.002
  23. Takkar B, 2017, INT OPHTHALMOL
  24. Tugal-Tutkun Ilknur, 2011, J Ophthalmic Vis Res, V6, P259
  25. Wentworth Bailey A, 2014, F1000Prime Rep, V6, P41, DOI 10.12703/P6-41