Uveitis in Children and Adolescents

Margaret H Chang; Jessica G Shantha; Jacob J Fondriest; Mindy S Lo; Sheila T Angeles-Han

doi:10.1016/j.rdc.2021.07.005

Uveitis in Children and Adolescents

Rheum Dis Clin North Am. 2021 Nov;47(4):619-641. doi: 10.1016/j.rdc.2021.07.005. Epub 2021 Aug 27.

Authors

Margaret H Chang¹, Jessica G Shantha², Jacob J Fondriest³, Mindy S Lo¹, Sheila T Angeles-Han⁴

Affiliations

¹ Division of Immunology, Boston Children's Hospital, Harvard Medical School, Fegan 6, 300 Longwood Avenue, Boston, MA 02115, USA.
² Department of Ophthalmology, Emory University, Emory Eye Center, 1365 Clifton Road, Clinic Building B, Atlanta, GA 30326, USA.
³ Department of Internal Medicine, Summa Health System, Internal Medicine Center, 55 Arch Street, Suite 1B, Akron, OH 44304, USA; Rush Eye Center, 1725 West Harrison Street, Suite 945, Chicago, IL 60612, USA.
⁴ Division of Rheumatology, Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA; Division of Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA. Electronic address: [email protected].

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.

Keywords: Autoimmune; Ophthalmology; Pediatrics; Rheumatology; Uveitis.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Adalimumab
Adolescent
Arthritis, Juvenile* / complications
Arthritis, Juvenile* / diagnosis
Arthritis, Juvenile* / drug therapy
Child
Humans
Infliximab
Methotrexate
Uveitis* / diagnosis
Uveitis* / drug therapy
Uveitis* / epidemiology

Substances

Infliximab
Adalimumab
Methotrexate

Abstract

Publication types

MeSH terms

Substances

Grants and funding