Pattern of Childhood-Onset Uveitis in a Referral Center in Tunisia, North Africa

Khairallah, Moncef; Attia, S.; Zaouali, Sonia; Yahia, Salim Ben; Kahloun, Rim; Messaoud, R.; Zouid, S.; Jenzeri, S.

doi:10.1080/09273940600732372

Cited by 45 publications

(30 citation statements)

References 19 publications

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“…The mean age of our patients was 9.2 years, which fell within the range of the averages found in other studies (6.7–12.4 years) 1,4,9–13. The majority of our patients were diagnosed with idiopathic pediatric uveitis (74%), while other studies report a wide range of unidentified or idiopathic etiology of pediatric uveitis: from 12.8% to 60% 1,4,7–13. Our rate of idiopathic etiology was higher than that reported in other studies, possibly due to some patients failing to receive sufficient follow-up (ie, some patients were unable to get bloodwork done or failed to follow-up at their rheumatology appointments).…”

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 60%

“…Some of the data from the more recent studies are included here for comparison to our study population 1,4,7–13. The mean age of our patients was 9.2 years, which fell within the range of the averages found in other studies (6.7–12.4 years) 1,4,9–13. The majority of our patients were diagnosed with idiopathic pediatric uveitis (74%), while other studies report a wide range of unidentified or idiopathic etiology of pediatric uveitis: from 12.8% to 60% 1,4,7–13.…”

Section: Discussionmentioning

confidence: 99%

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A 10-year review of pediatric uveitis at a Hispanic-dominated tertiary pediatric ophthalmic clinic

Dajee

Rossen²,

Bratton

et al. 2016

OPTH

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PurposeThe aim of this study was to evaluate the characteristics and outcomes of pediatric uveitis cases at a large tertiary referral center in Dallas, TX, USA.Materials and methodsThe authors performed a retrospective chart review between 2001 and 2011 to identify children with uveitis.ResultsA total of 46 children (68 eyes) with uveitis were identified. Sixty-seven percent were Hispanic, and the mean age was 9.2 years. The majority of cases were idiopathic (74%). Anterior uveitis accounted for 42% of cases followed by intermediate uveitis/pars planitis (33%), posterior uveitis/retinitis (7%), and panuveitis (20%). Most patients were treated with corticosteroids (98% topical), 52% with systemic immunosuppression therapy, and 30% with surgery. Complications occurred in 74% of patients, with the most common complication being cataract development (26%), followed by posterior synechiae (24%). Twenty-four percent of patients had recurrences. Hispanic patients had worse visual acuities at presentation (P-value =0.073) and follow-up (P-value =0.057), compared to non-Hispanic patients.ConclusionPediatric uveitis cases seen in a large center in Dallas were largely idiopathic, had commonly developed complications, and were associated with worse visual outcomes in Hispanic patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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A 10-year review of pediatric uveitis at a Hispanic-dominated tertiary pediatric ophthalmic clinic

Dajee

Rossen²,

Bratton

et al. 2016

OPTH

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“…Uveitis is more frequently diagnosed in younger adults: In our own experience, 48 out of 104 (46.1 %) difficult-to-treat patients with AU, followed up at a single tertiary reference center, were of \40 years at presentation [2]. There is a slightly higher prevalence in females (M/F ratio 0.68 to 0.95) [3][4][5][6], with few exceptions (M/F ratio 1.06 to 1.08) [7,8].…”

Section: Introductionmentioning

confidence: 96%

Autoimmune uveitis: clinical, pathogenetic, and therapeutic features

et al. 2015

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Autoimmune uveitis (AU), an inflammatory non-infectious process of the vascular layer of the eye, can lead to visual impairment and, in the absence of a timely diagnosis and suitable therapy, can even result in total blindness. The majority of AU cases are idiopathic, whereas fewer than 20 % are associated with systemic diseases. The clinical severity of AU depends on whether the anterior, intermediate, or posterior part of the uvea is involved and may range from almost asymptomatic to rapidly sight-threatening forms. Race, genetic background, and environmental factors can also influence the clinical picture. The pathogenetic mechanism of AU is still poorly defined, given its remarkable heterogeneity and the many discrepancies between experimental and human uveitis. Even so, the onset of AU is thought to be related to an aberrant T cell-mediated immune response, triggered by inflammation and directed against retinal or cross-reactive antigens. B cells may also play a role in uveal antigen presentation and in the subsequent activation of T cells. The management of AU remains a challenge for clinicians, especially because of the paucity of randomized clinical trials that have systematically evaluated the effectiveness of different drugs. In addition to topical treatment, several different therapeutic options are available, although a standardized regimen is thus far lacking. Current guidelines recommend corticosteroids as the first-line therapy for patients with active AU. Immunosuppressive drugs may be subsequently required to treat steroid-resistant AU and for steroid-sparing purposes. The recent introduction of biological agents, such as those targeting tumor necrosis factor-α, is expected to remarkably increase the percentages of responders and to prevent irreversible sight impairment. This paper reviews the clinical features of AU and its crucial pathogenetic targets in relation to the current therapeutic perspectives. Also, the largest clinical trials conducted in the last 12 years for the treatment of AU are summarized and critically discussed.

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“…10,11 Disc swelling has been reported to occur in up to 38% of cases with intermediate uveitis and may even occur in cases of severe anterior uveitis in children. 12,13 Thinning of the peripapillary retinal nerve fiber layer (RNFL) is associated with glaucoma and its measurement with optical coherence tomography (OCT) has been recommended as an adjunct to other methods of glaucoma detection in adult primary glaucomas. [14][15][16][17][18] It is noninvasive, quick, and relatively easy to perform, all of which gives significant advantage in children.…”

mentioning

confidence: 99%

Raised Intraocular Pressure in Nonjuvenile Idiopathic Arthritis-Uveitis Children: Risk Factors and Effect on Retinal Nerve Fiber Layer

Din

Tomkins-Netzer

Talat

et al. 2016

Journal of Glaucoma

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Pattern of Childhood-Onset Uveitis in a Referral Center in Tunisia, North Africa

Cited by 45 publications

References 19 publications

A 10-year review of pediatric uveitis at a Hispanic-dominated tertiary pediatric ophthalmic clinic

A 10-year review of pediatric uveitis at a Hispanic-dominated tertiary pediatric ophthalmic clinic

Autoimmune uveitis: clinical, pathogenetic, and therapeutic features

Raised Intraocular Pressure in Nonjuvenile Idiopathic Arthritis-Uveitis Children: Risk Factors and Effect on Retinal Nerve Fiber Layer

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