Clinical Outcomes and Management Challenges of Pediatric Uveitis Associated with Systemic Rheumatic Diseases

Abs tractAim: Pediatric uveitis is a sight-threatening condition associated with various systemic diseases.The prognosis depends on both the etiology and multidisciplinary management.This study evaluates the etiology, clinical characteristics, and outcomes of pediatric uveitis managed through a coordinated rheumatology-ophthalmology approach.Methods: This retrospective cross-sectional study included patients diagnosed before age 16 who were followed jointly for 6 months.Demographics, clinical presentations, underlying diseases, treatments, and outcomes were extracted from medical records.The primary endpoint of this study was to identify the systemic etiological spectrum of pediatric uveitis.The secondary endpoints were to evaluate clinical characteristics and the efficacy of various treatment modalities with respect to disease course and achievement of ocular remission (complete or partial) during follow-up.Results: Of the 109 enrolled patients, 73 patients with systemic disease-related uveitis were analyzed; 51% were female.Juvenile idiopathic arthritis (JIA) was the leading cause (70% of cases), followed by probable sarcoidosis (17.6%) and Behet's disease (BD) (11%).The mean age was 11.14.2years.Juvenile idiopathic arthritis was more prevalent in younger children; BD was more prevalent in older age groups.Anterior uveitis (71.2%), chronic course (74%), and bilateral involvement (75.3%) predominated.Antinuclear antibodies positivity was 64.4%.Treatment included systemic steroids (71%) and methotrexate/biologics (65.7%).Both sarcoidosis and BD groups demonstrated favorable outcomes: clinical remission was achieved in 12 of 13 (92.3%)sarcoidosis patients and 8 of 8 (100%) BD patients.Relapse rates were lower in sarcoidosis (7.7%) and BD (12.5%) than in the JIA group (55%).Complications were observed in 38.5% of sarcoidosis patients and 12.5% of BD patients. Conclusion: Pediatric uveitis requires aggressive immunosuppressive therapy