Purpose

Uveitis has a known association with multiple sclerosis (MS) in adults. Also, TNF-α inhibitors, which are being successfully used for the treatment of uveitis, could worsen the existing demyelination. The aim of this study is to analyse the prevalence of white matter abnormalities (WMA) in children with non-infectious uveitis (NIU) and to examine whether a correlation can be seen between WMA and type of uveitis.

Methods

Medical records of children, <18 years old, with all types of NIU that underwent a cerebral MRI to look for abnormalities were analysed retrospectively.

Results

55 children that underwent a cerebral MRI were included of which 37 (67.2%) were scanned before starting TNF-α inhibitors. Of all children that underwent a MRI, nine (16.4%) were diagnosed with anterior uveitis, 14 (25.5%) with intermediate uveitis and 32 (58.2%) with panuveitis. A total of 11 children (20.0%), two with intermediate uveitis and nine with panuveitis, showed abnormalities on cerebral MRI. Of the patients with non-anterior uveitis, 23.9% were found to have abnormalities on MRI. None of the children with anterior uveitis showed WMA. Of the 11 patients with abnormalities, nine patients showed (atypical) WMA. One patient showed optic nerve atrophy and one, with neurological symptoms, showed leptomeningeal enhancement suspected for sarcoidosis. Nine patients with abnormalities were scanned before the initiation of a biological therapy. The other three were scanned because of papilloedema (n=2) and neurological symptoms (n=1).

Conclusions

In this study, 20% of all children that underwent a cerebral MRI showed abnormalities on MRI. Of the children with non-anterior uveitis, 23.9% were found to have abnormalities. In contrast, none of the children with anterior uveitis showed abnormalities on MRI.