FRI0574 CLINICAL RESPONSE TO HIGH-DOSE INTRAVENOUS METHYLPREDNISOLONE IN CHILDHOOD AUTOIMMUNE UVEITIS: A RETROSPECTIVE ANALYSIS

Abstract

Background Intraocular inflammation accounts for up to 10-15% of total blindness cases [1]. The incidence of uveitis in children ranges around 4.9/100.000, and a significant number of patients develop chronic courses and irreparable complications [2]. An impressive 74% of children with juvenile idiopathic arthritis (JIA)-associated uveitis are legally blind at diagnosis [3]. This underscores the importance of timely diagnosis and effective anti-inflammatory treatment. Objectives To evaluate the clinical response to high-dose intravenous methylprednisolone (IVMP) in children and adolescents with autoimmune uveitis. Methods A retrospective chart review was conducted in two tertiary referral centers in Germany (TU Dresden and University of Wurzburg) to investigate treatment responses to IVMP (10-30mg/kg/day on three successive days with a total of one to five IVMP at monthly intervals) in children and adolescents ( Results Fifty-six patients (93 affected eyes) with a median age of 7.4 (range: 2.5-16.7) years were included. In 29% of patients uveitis was associated with JIA. Uveitis was predominately located in the anterior segment (43%), bilateral (66%) and recurrent (43%). Complications occurred in 77% of patients and included visual loss, synechiae, cataract and/or retinal lesions. Patients with active uveitis received between 1 and 5 IVMP. Visual acuity improved significantly (0.52±0.33 to 0.69±0.30 at 3 months (p Conclusion High-dose IVMP induces rapid improvement in children with autoimmune uveitis. Data suggest improved outcomes in children treated with three or more courses of IVMP when compared to one course (without reaching statistical significance). Prospective randomized trials in larger cohorts are required to confirm results.