Paediatric uveitic glaucoma and cataract in the time of biologic therapy
Purpose
To investigate rates, timing and visual outcomes of paediatric uveitic glaucoma and cataract in relation to the diagnosis and treatment of the uveitis with steroid sparing / biologic immunosuppression.
Methods
Retrospective chart review of all paediatric uveitis patients presenting to the Children’ s Hospital Westmead, Sydney Eye Hospital and Save Sight Institute from 2005- 2020.
Results
111 patients (207 eyes) diagnosed with paediatric uveitis 2005-2020. The majority had bilateral uveitis (n = 89, 80%), 61 patients were female and 48 patients male, the most common aetiological diagnosis was JIA-U (n =65 , 59%), followed by idiopathic uveitis (n = 33, 29.6%) and anatomical diagnosis was 84% anterior uveitis and 16% non-anterior uveitis. Over 50% eyes diagnosed with uveitis developed raised IOP, close to 50% presumed to be steroid induced,
43 eyes (21%) had glaucoma surgery, 35 eyes had glaucoma drainage devices, 15 eyes had trabeculectomy surgery - the majority prior to 2017. Some eyes had two operations.
Conclusion
Control of intraocular inflammation is essential. There should be a
rapid taper any systemic steroids, minimise topical steroid therapy to < 3 x per day (as OHT dose dependent), < 3 months duration, commence step ladder systemic more quickly ( IMT - MTX - Biologic)
Conflict of interest
No
Authors 1
Last name
ZAGORA
Initials of first name(s)
SL
Department
Ophthalmology, Sydney Eye Hospital, University of Sydney and Westmead Children' Hospital
City
Sydney
Country
Australia
Authors 2
Last name
Karaconji
Initials of first name(s)
TK
Department
Ophthalmology, Sydney Eye Hospital, University of Sydney and Westmead Children' Hospital
City
Sydney
Country
Australia
Authors 3
Last name
McCluskey
Initials of first name(s)
PJ
Department
Ophthalmology, Sydney Eye Hospital, University of Sydney
City
Sydney
Country
Australia
Authors 4
Last name
Grigg
Initials of first name(s)
J
Department
Ophthalmology, Sydney Eye Hospital, University of Sydney and Westmead Children' Hospital
City
Sydney
Country
Australia
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