Clinical characteristics and outcomes of pediatric anterior and intermediate uveitis in China.

PURPOSE: To summarize the clinical characteristics of pediatric anterior and intermediate uveitis (PAIU) and evaluate the effectiveness of vitreous cell (VC) grading and multimodal imaging techniques in the diagnosis and management of PAIU cases.

METHODS

This retrospective study analyzed data on demographic characteristics, clinical features, treatment methods, and responses. Imaging tests included optical coherence tomography (OCT) and ultra-widefield fluorescein angiography (UWFFA) to assess retinal thickness, peripheral vascular leakage (PVL), and other inflammatory indicators.

RESULTS

Eighty-eight PAIU cases accounted for 23 % of pediatric uveitis (median age at onset: 10.5 years (Range 1.0-16.0); 90.9 % bilateral, 96.6 % idiopathic). Initial symptoms included eye redness (74.4 %), blurred vision (27.5 %), pain (23.8 %), and photophobia (21.3 %), but 20.6 % were asymptomatic. Initial evaluations revealed active anterior chamber cell (ACC) and mild VC. UWFFA revealed diffuse PVL in 76.2 % of patients and limited PVL in 23.8 %. OCT revealed a significant positive correlation between retinal thickness and ACC or VC grading (P < 0.05). Compared to OCT, VC grading demonstrates greater sensitivity to disease progression during late-stage follow-up. Most eyes (87.7 %) achieved inflammation control with median treatment of 3.3 months (Interquartile range 1.2-6.2), short referral time and initial methotrexate use being independent prognostic factors. However, 32.2 % of eyes experienced the first recurrent episode during a median follow-up of 15.3 months (Interquartile range, 5.7-23.8); long referral time was an independent prognostic factor for relapse.

CONCLUSION

Patients with PAIU present with inflammation involving both anterior segment, vitreous and peripheral retina and need systemic treatment. Monitoring of VC, macular edema, and PVL using multimodal imaging techniques are crucial for early diagnosing and long-term management of PAIU.