Journal of Clinical and Experimental Ophthalmology
Open Access

Strategies for the restriction of cumulative damages in cases with pediatric uveitis

3^rd Global Pediatric Ophthalmology Congress

March 22-23, 2018 | London, UK

Chris D Kalogeropoulos

University of Ioannina, Greece

Posters & Accepted Abstracts: J Clin Exp Ophthalmol

Abstract :

Statement of the Problem: Children and adolescents with recurrent and chronic uveitis are at risk of complications threatening the anatomical and functional integrity of the eye. Methodology & Theoretical Orientation: Published data and also the data from the clinical practice (patient�s files) in a referral tertiary Academic Hospital was analysed. Uveitis complications due to cumulative damages and the appropriate management to prevent those situations and also to treat successfully the problem, creating algorithms with regard to the used therapeutic procedures, were studied. Findings: In cases of infectious uveitis identification of microbial agent is imperative since early and appropriate antimicrobial treatment is required. In cases with non-infectious uveitis, the exploration for an associated systemic disease (when the eye is the first target) is also of crucial importance giving an orientation for the further management and collaboration with pediatricians. Although the majority of cases of pediatric uveitis are idiopathic most published series report juvenile idiopathic arthritis as the most common identifiable cause of uveitis in children with sarcoidosis being a remote second. Cataract, glaucoma, cystoid macular edema, cyclitic membranes are prominent complications. According to our analysis earlier and adequate control of inflammation reduces the rate of visual loss. In cases of established cumulative damages surgery may be necessary. Studies demonstrate that control of uveitis for three months or more and intensive per operative anti-inflammatory therapy both reduced the risk of postoperative macular edema. Steroids and immuno modulators including mainly methotrexate are generally recommended. In addition, other agents are used with promising results (inhibitors of tumor necrosis factor-a; recent studies using adalimumab for pediatric noninfectious uveitis have shown promising results). Conclusion & Significance: The early diagnosis and appropriate treatment in cases of pediatric uveitis contribute to the restriction of cumulative damage in uveitic eyes. Analysis of data helps to establish strategies for the management steps. kalogch@otenet.gr