Purpose

To determine the efficacy and long-term effects of biologic agents on non-infectious pediatric uveitis, in terms of disease control, effect on vision and steroid-sparing effect.

Methods

Retrospective review of medical charts of patients.

Results

Included were 50 patients (84 eyes), of whom 35 were females (70%). Mean age at time of diagnosis of uveitis was 7.22±4.04 years. At baseline, all patients had active uveitis. Mean total follow-up was 4.86±2.82 years and mean follow-up after baseline was 38.62±31.29 months. Complete control of ocular inflammation was achieved in 84.52% (n=71) of eyes. Mean LogMAR BCVA at baseline was 0.23 ±0.44 and it remained stable at 12 and 24 months after baseline (0.15±0.40 and 0.18±0.41, respectively). At baseline, mean dose of prednisone was 13.70±13.47 mg/day and it decreased to 3.82±3.02 mg/day (p<0.0001) and 2.84±2.81 mg/day (p<0.0001) at 12 and 24 months after baseline. At baseline, 64% (n=32) of patients were dependent on oral corticosteroids and this decreased to 29.54% (n=13) at 12 months (p=0.001) and to 21.8% (n=7) at 24 months (p<0.001). At baseline, 34 (42.5%) eyes used topical steroids, at a mean dose of 1.04±1.77 drops/day, this decreased at 12 months, with 4 eyes (6.3%) still using topical corticosteroids (p<0.0001), at a mean of 0.14±0.47 drops/day and remained stable at 24 months. 20 eyes (23.8%) experienced flare, at a mean of 10.07±11.72 months (range 5 to 24). Rate of treatment failure was 10% (5 patients): 2 were treated with adalimumab and 3 with infliximab.

Conclusions

Ocular disease was effectively controlled with biologic agents in 84.52% of eyes. The use of biologic agents allowed visual stabilization and significantly exerted oral and topical corticosteroid-sparing effect.