Paediatric uveitis in India
Reviewed by Saruban Pasu

This article was a retrospective review of paediatric patients presenting to a tertiary hospital in India. Records over a three year period were reviewed. The authors highlight that children account for about 2.2-13.8% of uveitis patients and are at greater risk of developing complications from the condition. During the study period, 190 children were diagnosed with uveitis, 64.2% were males and a median age at presentation of 11 years. The sex and age distribution was similar across the spectrum of cases. Bilateral disease was seen more commonly in intermediate and panuveitis patients. Anterior uveitis was diagnosed in 52% of cases, 26% were intermediate, 14% posterior and 8% were panuveitis. Idiopathic cases accounted for 36% anterior, 55% intermediate, 19% posterior and 20% of panuveitis cases. Juvenile idiopathic arthritis (JIA) accounted for 22% of anterior uveitis, parasitic uveitis accounted for 60% of posterior uveitis, and Vogt Koyanagi Harada syndrome (VKH) accounted for 40% of panuveitis. Trauma accounted for 14% of anterior uveitis cases. Overall, 23% were diagnosed with an infectious uveitis (14 TB, 18 parasisitic, 12 viral). Sixty-five were treated with only topical steroids, 54 had topical and oral treatment and 15 needed periocular steroids with topical treatment. Forty-five were started on immunomodulatory therapy with topical and / or oral steroids. Cataract was the most common complication noted, occurring at a rate of 44%. Raised IOP and band keratopathy were noted in 14.4% cases. Macular oedema occurred in 5.5% of cases; 11.1% were complicated by retinal detachment, hypotony in 2.2% and choroidal neovascular membrane with subretinal fibrosis in 4.4% of cases. Surgical procedures were needed in 28.9%, with cataract extraction being the most common procedure (80%). Visual acuity improved in 69% of cases, was stable in 23% and deteriorated in 8%. Prognosis was poor in patients presenting at a younger age, those with a longer duration of uveitis, and those who had longer duration of disease before being referred to a specialist. Risk of amblyopia, poor tolerance to drugs, development of side-effects to medication, and poor compliance pose difficulties in medical management in children.

Pattern of pediatric uveitis seen at a tertiary referral center from india.
Ganesh S, Bala A, Biswas J, et al.
OCULAR IMMUNOLOGY AND INFLAMMATION
2016;24(4):402-9.