Título

CLINICAL FEATURES OF PEDIATRIC UVEITIS AT A TERTIARY REFERRAL CENTER IN SAO PAULO, SP, BRAZIL

Objetivo

To analyze clinical features, systemic associations, treatment and visual outcomes of uveitis in children from referral center in São Paulo, SP, Brazil.

Método

Clinical records of patients under 16 years old who were followed up at Uveitis Service, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo between April and September 2017 were reviewed retrospectively. Patients with incomplete medical records, previous ocular trauma or less than 6 months of follow-up were excluded. Study approved by Institutional Ethics Committee (CapPesq 2.289.047) and was conducted in accordance with principles of Declaration of Helsinki.

Resultado

Thirty-nine children (25F/14M) were included. There was predominance of bilateral (89.7%), asymptomatic (56.4%) and recurrent/chronic cases (84.6%). Median age at study inclusion was 10.7±3.4 years old (range 3–16 years). Visual acuity (VA) ≥ 20/60 in better eye was observed in 74% of patients at first visit and in 90% at final visit. Patients were referred early to tertiary center (55% within 6 months of uveitis diagnosis). Anterior uveitis was most common involvement (46%) followed by intermediate uveitis (26%). Juvenile idiopathic arthritis (JIA)-associated uveitis (41%) and immune-mediated intermediate uveitis (25.6%) were principal non-infectious conditions; ocular toxoplasmosis (7.7%) and toxocariasis (5.1%) were most common infectious conditions. Ocular complications were observed at first visit in 46% of patients and in 90% during final evaluation. Oral prednisone was 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.

Conclusão

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