Changing paediatric uveitis patterns in Italy: an eight-year experience from the Reggio Emilia Uveitis clinic.

PURPOSE: To determine the aetiological, clinical, and therapeutic features of children diagnosed with uveitis in a tertiary referral centre in Northern Italy.

METHODS

Evaluation of medical data of all new paediatric (≤ 16 years old) referrals to the Ocular Immunology Unit of Reggio Emilia (Northern Italy) between November 2015 and December 2023. An interdisciplinary diagnostic-therapeutic pathway-based approach was adopted for all patients.

RESULTS

Among a pool of 263 patients, the male-to-female ratio was 1:1.32. Anterior uveitis was the most common diagnosis (45.2%), followed by pan-(23.6%), intermediate (16.7%), and posterior (14.5%) uveitis. The most identifiable specific diagnoses were juvenile idiopathic arthritis (JIA) (27.8%), Vogt-Koyanagi-Harada disease (8.7%), and toxoplasmosis (6.8%). Non-infectious systemic disease aetiologies were the most frequent (47.5%), followed by infectious uveitis (15.2%) and non-infectious ocular-specific conditions (2.7%). Idiopathic uveitis accounted for 34.6% of cases. Immunosuppressants were administered in 58.5% of patients. Antimetabolites, calcineurin inhibitors, and biologics were prescribed in 52.5%, 4.6% and 31.6% of cases, respectively. Methotrexate, adalimumab, and azathioprine were the most commonly prescribed immunosuppressants (29.3%, 26.6%, and 21.7% of patients, respectively). JIA-associated uveitis is the type most associated with surgical procedures (39.7%).

CONCLUSIONS

The patterns of uveitis in children differ from those in adults, with infectious aetiologies being less common and idiopathic uveitis accounting for the majority of cases. However, the frequency of idiopathic uveitis in Italy is decreasing. Nowadays, a wide range of immunosuppressants are used for the treatment of paediatric uveitis.