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Open AccessJournal ArticleDOI

Risk Factors for the Development of Cataract in Children with Uveitis

TLDR
It is found that development of cataract is common among pediatric eyes with uveitis and is most strongly related to the extent of inflammation recurrences and ocular complications and it is suggested that controlling the inflammation, even using higher doses of systemic and topical corticosteroids, is of importance in preventing ocular complication.
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This article is published in American Journal of Ophthalmology.The article was published on 2017-05-01 and is currently open access. It has received 36 citations till now. The article focuses on the topics: Intermediate uveitis & Uveitis.

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Citations
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A Review of Complicated Cataract in Retinitis Pigmentosa: Pathogenesis and Cataract Surgery.

TL;DR: In this paper, the authors discuss the current understanding of retinitis pigmentosa (RP) patients with complicated cataracts from morphology to potential pathogenesis to cataract surgical procedure and provide a concise description and the recommended management of related surgery complications to broaden the knowledge and lower the latent risks to yield better clinical outcomes.
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Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort.

TL;DR: Paediatric-onset uveitis are associated with a high rate of complications, however, following the introduction of biologics and particularly antitumour necrosis factor alpha antibodies, a significant proportion of Uveitis became inactive on or even off treatment.
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Pediatric uveitis: A comprehensive review.

TL;DR: The stepladder approach for the treatment of pediatric uveitis is based on expert opinion and algorithms proposed by multidisciplinary panels as mentioned in this paper, and the most common causes of Uveitis in this age group are idiopathic and juvenile idiopathy and arthritis-associated UVEitis.
Journal ArticleDOI

Pediatric uveitis: A comprehensive review

TL;DR: The stepladder approach for the treatment of pediatric uveitis is based on expert opinion and algorithms proposed by multidisciplinary panels as mentioned in this paper , and the most common causes of Uveitis in this age group are idiopathic and juvenile idiopathy and arthritis-associated UVEitis.
Journal ArticleDOI

An Immune Response to the Avascular Lens Following Wounding of the Cornea Involves Ciliary Zonule Fibrils

TL;DR: It is demonstrated that lens‐associated ciliary zonules are directly involved in the lens immune response and suggested the ciliary body as a source of immune cells to the avascular lens.
References
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Journal ArticleDOI

Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop.

TL;DR: In this article, a process of standardizing the methods for reporting clinical data in the field of uveitis has been discussed, and the results used to develop a series of proposals to better standardize the use of these entities.
Journal ArticleDOI

The natural history of uveitis.

TL;DR: The better understanding of ocular inflammatory mechanisms has led to improved therapeutic strategies, including Sandimmune, and more recently Cyclosporine G, a related compound that may be less nephrotoxic.
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Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: a long-term followup study

TL;DR: The long-term outcome of JIA-associated uveitis in patients diagnosed as having JIA at a single tertiary care center was excellent despite the high rate of complications.
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Visual loss in uveitis of childhood

TL;DR: Uveitis in childhood is a potentially blinding disease, in the majority of patients characterised by a chronic course and a high complication rate.
Journal ArticleDOI

Ocular complications of pediatric uveitis.

TL;DR: The cumulative proportion and the visual significance of ocular complications of pediatric uveitis and the time to development of complications, and vision loss after initial diagnosis are determined.
Related Papers (5)
Frequently Asked Questions (12)
Q1. What have the authors contributed in "Risk factors for the development of cataract in children with uveitis" ?

In this paper, the authors examined disease and treatment related risk factors for cataract development in children with uveitis of any etiology. 

refractory disease mandates the use of more potent treatment options for extensive periods of time, and cataract formation may be the result of either the long standing activeinflammation, or as a consequence of corticosteroids. 

The most common etiologies related to cataract were idiopathic (48.6%), JIA (12.9%), antinuclear antibody (ANA) positive vasculitis with no evidence of joint involvement (8.6%), infections (such as acute retinal necrosis, tuberculosis, toxoplasmosis and human immunodeficiency virus infections- 7.8%), idiopathic posterior uveitis (multi focal choroiditis and acute multifocal placoid pigment epitheliopathy- 5.7%), HLA-B27 positive (5%) and Sarcoidosis (4.3%). 

The prolonged exposure to local inflammatory mediators is known to be related to the development of anterior chamber complications,23 among which cataract formation has the greatest visual impact. 

One of the reasons for the development of cataract in uveitis may be a consequence of ongoing inflammation and the anatomical location of this inflammation is an important factor. 

Risk of cataract development among children with juvenile idiopathic arthritis-related uveitis treated with topical corticosteroids. 

Among types of uveitis PanU was found to be a statistically significant risk factor for cataract development (p=0.02), while CAU was related to an increased risk of cataract development, but did not reach statistical significance (p=0.07). 

Complications of uveitis are considered more prevalent in children than in adults due to delayed diagnosis as well as difficulty in clinical examination and treatment, with the most common complication being cataract. 

Amongst their cohort, cataract developed most commonly in eyes with PanU, CAU and IU respectively, whereas it was far less common in those with PostU, despite extensive use of systemic corticosteroids and local corticosteroids injections,5 suggesting inflammation is a far more significant risk factor. 

To conclude, in this study the authors found that formation of cataract is common among pediatric eyes treated for uveitis and may develop over several years. 

The mean follow up time was 51.6±3.4 months (range 6-261 months)and the prevalence of cataract in the entire cohort was 44.2% of eyes and occurred in 12.9% of eyes with acute anterior uveitis (AAU), 48.3% of those with chronic anterior uveitis (CAU), 48.0% with intermediate uveitis (IU), 16.7% with posterior uveitis (PostU) and 77.1% with panuveitis (PanU). 

The authors investigated clinical and ophthalmological characteristics, as well as treatment strategies in relation to the time interval between the first presentation with uveitis and cataract development.