Uveitis in Children and Adolescents

• Authors: Margaret H Chang, Harvard Medical School; Jessica Shantha, Emory University; Jacob J Fondriest, Internal Medicine Center; Mindy S Lo, Harvard Medical School; Sheila Angeles-Han, Emory University
• Journal Title: RHEUMATIC DISEASE CLINICS OF NORTH AMERICA
• Volume: Volume 47, Number 4
• Publisher: W B SAUNDERS CO-ELSEVIER INC | 2021-10-08, Pages 619-641
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.rdc.2021.07.005
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Rheumatology; Pediatrics; Uveitis; Ophthalmology; Autoimmune; JUVENILE IDIOPATHIC ARTHRITIS; RHEUMATOLOGY/ARTHRITIS FOUNDATION GUIDELINE; KOYANAGI-HARADA SYNDROME; 2019 AMERICAN-COLLEGE; RHEUMATOID-ARTHRITIS; BEHCETS-DISEASE; TUBULOINTERSTITIAL NEPHRITIS; PEDIATRIC UVEITIS; INTERMEDIATE UVEITIS; OCULAR COMPLICATIONS

Abstract

Childhood noninfectious uveitis leads to sight-threatening complications. Idiopathic chronic anterior uveitis and juvenile idiopathic arthritis-associated uveitis are most common. Inflammation arises from an immune response against antigens within the eye. Ophthalmic work-up evaluates anatomic involvement, disease activity, ocular complications, and disease course. Local and/or systemic glucocorticoids are initial treatment, but not as long-term sole therapy to avoid glucocorticoids-induced toxicity or persistent ocular inflammation. Children with recurrent, refractory, or severe disease require systemic immunosuppression with methotrexate and/or anti-tumor necrosis factor monoclonal antibody medications (adalimumab, infliximab). Goals of early detection and treatment are to optimize vision in childhood uveitis.