Uveitis in children - prevalence, incidence, epidemiology, visual outcome, treatment and ocular complications
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
OYS lecture hall/auditorium 3
Topic of the dissertation
Uveitis in children - prevalence, incidence, epidemiology, visual outcome, treatment and ocular complications
Doctoral candidate
MD, ophthalmologist Mira Siiskonen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine
Subject of study
Ophthalmology
Opponent
docent Hannele Uusitalo-Järvinen, University of Tampere
Custos
professor Nina Hautala, University of Oulu
Uveitis in children - commonness, causes, visual outcome, treatment and ocular complications
Uveitis in pediatric patients is rare, mostly asymptomatic, anterior in location, bilateral, chronic and often resistant to treatment. Uveitis in children differs from the adult-onset inflammatory disease and is often challenging to diagnose in accordance with therapeutic and diagnostic aspects. Ocular complications of uveitis, such as glaucoma, cataract, band keratopathy and amblyopia have a significant impact on the visual function of the children.
In a retrospective, population-based study we investigated the prevalence, incidence and etiology of childhood uveitis in the Northern Ostrobothnia hospital district between 2008‒2017. The prevalence and incidence of pediatric uveitis was shown to be increased during the last decade in both sexes. The uveitis was found to be non-infectious in most of the pediatric patients. An increased risk of uveitis was associated with young age, female sex and presence of juvenile idiopathic arthritis.
In the longitudinal, population-based study cohort, visual outcomes and the effect of medication on uveitis activity in autoimmune uveitis was evaluated and the results were compared in patients with idiopathic uveitis (no other disease than uveitis) and juvenile idiopathic arthritis associated uveitis (JIA-U). Children with uveitis had good visual acuity and only a few suffered from unilateral visual impairment. Improved treatment in combination with disease-modifying antirheumatic drugs/corticosteroid spearing agents and biologic therapy seemed to save vision in the pediatric population with uveitis.
In the third study, we compared the ocular complications in patients with anterior uveitis with or without juvenile idiopathic arthritis. Secondary glaucoma, ocular hypertension and cataract were the most common complications of childhood uveitis. The patients with only uveitis had more vision-threating ocular complications than those with JIA-U. JIA-U patients with severe form of uveitis, female sex and young age at uveitis onset predisposed for surgical treatment. Screening for JIA-U and targeted treatment of uveitis has improved prognosis of pediatric uveitis, despite the occurrence of ocular complications.
In a retrospective, population-based study we investigated the prevalence, incidence and etiology of childhood uveitis in the Northern Ostrobothnia hospital district between 2008‒2017. The prevalence and incidence of pediatric uveitis was shown to be increased during the last decade in both sexes. The uveitis was found to be non-infectious in most of the pediatric patients. An increased risk of uveitis was associated with young age, female sex and presence of juvenile idiopathic arthritis.
In the longitudinal, population-based study cohort, visual outcomes and the effect of medication on uveitis activity in autoimmune uveitis was evaluated and the results were compared in patients with idiopathic uveitis (no other disease than uveitis) and juvenile idiopathic arthritis associated uveitis (JIA-U). Children with uveitis had good visual acuity and only a few suffered from unilateral visual impairment. Improved treatment in combination with disease-modifying antirheumatic drugs/corticosteroid spearing agents and biologic therapy seemed to save vision in the pediatric population with uveitis.
In the third study, we compared the ocular complications in patients with anterior uveitis with or without juvenile idiopathic arthritis. Secondary glaucoma, ocular hypertension and cataract were the most common complications of childhood uveitis. The patients with only uveitis had more vision-threating ocular complications than those with JIA-U. JIA-U patients with severe form of uveitis, female sex and young age at uveitis onset predisposed for surgical treatment. Screening for JIA-U and targeted treatment of uveitis has improved prognosis of pediatric uveitis, despite the occurrence of ocular complications.
Last updated: 29.4.2024