Modern Pediatrics. Ukraine. (2024). 7(143): 26-33. doi: 10.15574/SP.2024.7(143).2633
Oshlyanska O. A., Shevchenko I. I.
Shupyk National University of Healthcare of Ukraine, Kyiv

For citation: Oshlyanska OA, Shevchenko II. (2024). Features of the course of non-infectious uveitis in children in Ukraine. Modern Pediatrics. Ukraine. 7(143): 26-33. doi: 10.15574/SP.2024.7(143).2633.
Article received: Jun 16, 2024. Accepted for publication: Nov 12, 2024.

Uveitis that develops in childhood has a potentially severe course and can lead to vision loss.
Аim is to study the manifestations, structure and features of the course of idiopathic uveitis and uveitis in children with rheumatic diseases.
Materials and methods. During 2022-2023 49 children with uveitis were studied, of which 45 patients had a non-infectious (autoimmune) nature of the disease. The results of uveitis activity scales, quality of life in children with autoimmune uveitis and rheumatic diseases were evaluated. Descriptive and correlation analysis were used as analytical and statistical methods.
The results. According to the results of the study, children were observed for idiopathic uveitis, 29 children had inflammation of eye structures associated with juvenile idiopathic arthritis (JIA). The frequency of actual uveitis screening is once every 5.7±1.67 months. In 39.5% of cases, uveitis started asymptomatically. The average age at the time of diagnosis was 10.5±4.1 years. Among patients with non-infectious uveitis, girls predominated, the ratio of boys to girls was 1:2, gender differences were more characteristic of JIA-associated uveitis. Among JIA subtypes, the oligoarticular variant accounted for half of cases with JIA-associated uveitis. Anterior uveitis was unilateral in 60.5% of cases. Eye complications were observed in almost half of the patients. Laboratory markers ANA and HLA B27 were more likely to be detected in patients with JIA-associated uveitis, which made it possible to consider their detection in patients with idiopathic uveitis as a potential risk factor for the development of rheumatic disease. Treatment of children with idiopathic uveitis was significantly less active, which requires further study.
Conclusions. In recent years, the situation with the assessment of the quality of life in medicine has improved, relevant questionnaires are being actively implemented. There remains ambiguity in the results in world medicine regarding the availability of works on determining the relevance of the problem of the quality of life of children with JIA in Ukraine.
The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Сommittee on bioethics and deontology of these institutions. The informed consent of the children's parents was obtained for the research.
No conflict of interests was declared by the authors.
Keywords: children, uveitis, rheumatic diseases, juvenile idiopathic arthritis.

REFERENCES

1. Abd El Latif E, Fayez Goubran W, El Gemai EEDM, Habib AE, Abdelbaki AM et al. (2019). Pattern of childhood uveitis in Egypt. Ocul Immunol Inflamm. 27(6): 883-889. https://doi.org/10.1080/09273948.2018.1502325; PMid:30148647

2. American Academy of Pediatrics Section on Rheumatology and Section on Ophthalmology. (1993). Guidelines for ophthalmologic examinations in children with juvenile rheumatoid arthritis. Pediatrics. 92(2): 295-296. https://doi.org/10.1542/peds.92.2.295

3. Angeles-Han ST, Griffn KW, Lehman TJ et al. (2010). The importance of visual function in the quality of life of children with uveitis. JAAPOS. 14(2): 163-168. https://doi.org/10.1016/j.jaapos.2009.12.160; PMid:20236847 PMCid:PMC2866793

4. Angeles-Han ST, Pelajo CF, Vogler LB, Rouster-Stevens K, Kennedy C, Ponder L et al. (2013). Risk markers of juvenile idiopathic arthritis-associated uveitis in the childhood arthritis and rheumatology research Alliance (CARRA) registry. J Rheumatol. 40(12): 2088-2096. https://doi.org/10.3899/jrheum.130302; PMid:24187099 PMCid:PMC4117408

5. BenEzra D, Cohen E, Behar-Cohen F. (2007). Uveitis and juvenile idiopathic arthritis: a cohort study. Clin Ophthalmol. 1(4): 513-518.

6. BenEzra D, Cohen E, Maftzir G. (2005). Uveitis in children and adolescents. Br J Ophthalmol. 89(4): 444-448. https://doi.org/10.1136/bjo.2004.050609; PMid:15774921 PMCid:PMC1772593

7. Bogmat L, Fadieieva A, Shevchenko N. (2022). Quality of life problems in children with juvenile idiopathic arthritis and its subtype associated with uveitis (literature review and own research). Child's health, 16(4): 270-278. https://doi.org/10.22141/2224-0551.16.4.2021.236904

8. Boiko YaIe. (2016). Uveit u khvorykh na yuvenilnyi idiopatychnyi artryt. Ukrainskyi revmatolohichnyi zhurnal. 66(4): 23-34.

9. Brewerton DA, Caffrey M, Nicholls A, Walters D, James DC. (1973). Acute anterior uveitis and HL-A 27. Lancet. 302(7836): 994-996. https://doi.org/10.1016/S0140-6736(73)91090-8; PMid:4127279

10. Carvounis PE, Herman DC, Cha S, Burke JP. (2006). Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature. Graef. Arch. Clin. Exp. Ophthalmol. 244(3): 281-290. https://doi.org/10.1007/s00417-005-0087-3; PMid:16228217

11. Cassidy J, Kivlin J, Lindsley C, Nocton J. (2006). Section on rheumatology; section on ophthalmology. Ophthalmologic examinations in children with juvenile rheumatoid arthritis. Pediatrics. 117(5): 1843-1845. https://doi.org/10.1542/peds.2006-0421; PMid:16651348

12. Constantin T, Foeldvari I, Anton J, de Boer J, Czitrom-Guillaume S, Edelsten C et al. (2018). Consensus-based recommendations for the management of uveitis associated with juvenile idiopathic arthritis: the SHARE initiative. Ann Rheum Dis. 77(8): 1107-1017. https://doi.org/10.1136/annrheumdis-2018-213131; PMid:29592918 PMCid:PMC6059050

13. De Boer J, Wulffraat N, Rothova A. (2003). Visual loss in uveitis of childhood. Br J Ophthalmol. 87(7): 879-884. https://doi.org/10.1136/bjo.87.7.879; PMid:12812891 PMCid:PMC1771761

14. Edelsten C, Reddy MA, Stanford MR, Graham EM. (2003). Visual loss associated with pediatric uveitis in english primary and referral centers. Am J Ophthalmol. 135(5): 676-680. https://doi.org/10.1016/S0002-9394(02)02148-7; PMid:12719076

15. Heiligenhaus A, Foeldvari I, Edelsten C et al. (2012). Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis: a consensus effort from the multinational interdisciplinary working group for uveitis in childhood. Arthritis Care Res (Hoboken). 64(9): 1365-1372. https://doi.org/10.1002/acr.21674; PMid:22438273

16. Heiligenhaus A, Michels H, Schumacher C et al. (2012). Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Rheumatol. Int. 32(5): 1121-1133. https://doi.org/10.1007/s00296-011-2126-1; PMid:22083610

17. Heiligenhaus A, Mingels A, Heinz C, Ganser G. (2007). Methotrexate for uveitis associated with juvenile idiopathic arthritis: value and requirement for additional anti-inflammatory medication. Eur. J. Ophthalmol. 17: 743-748. https://doi.org/10.1177/112067210701700509; PMid:17932849

18. Heiligenhaus A, Niewerth M, Ganser G, Heinz C, Minden K et al. (2007). Prevalence and complications of uveitis in juvenile idiopathic arthritis in a population-based nation-wide study in Germany: suggested modification of the current screening guidelines. Rheumatology (Oxford). 46(6): 1015-1019. https://doi.org/10.1093/rheumatology/kem053; PMid:17403710

19. Horneff G. (2009). Uveitis bei entzündlich-rheumatischen Erkrankungen im Kindes- und Jugendalter. In: Gerd Horneff. Juvenile idiopathische Arthritis [Gebundene Ausgabe] UNI-MED Auflage: 1 (1 Mai 2009): 109-120 (144 Seiten).

20. Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature (SUN) Working Group. (2005). Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol. 140(3): 509-516. https://doi.org/10.1016/j.ajo.2005.03.057; PMid:16196117 PMCid:PMC8935739

21. Kadayifçilar S, Eldem B, Tumer B. (2003). Uveitis in childhood. J Pediatr Ophthalmol Strabismus. 40(6): 335-340. https://doi.org/10.3928/0191-3913-20031101-06; PMid:14655981

22. Keino H, Watanabe T, Taki W, Nakayama M, Nakamura T et al. (2017). Clinical features of uveitis in children and adolescents at a tertiary referral Centre in Tokyo. Br J Ophthalmol. 101(4): 406-410. https://doi.org/10.1136/bjophthalmol-2015-308194; PMid:27335142

23. Khairallah M, Attia S, Zaouali S, Yahia SB, Kahloun R, Messaoud R et al. (2006). Pattern of childhood-onset uveitis in a referral center in Tunisia, North Africa. Ocul Immunol Inflamm. 14(4): 225-231. https://doi.org/10.1080/09273940600732372; PMid:16911984

24. Kump LI, Cervantes-Castañeda RA, Androudi SN, Foster CS. (2005). Analysis of pediatric uveitis cases at a tertiary referral center. Ophthalmology. 112(7): 1287-1292. https://doi.org/10.1016/j.ophtha.2005.01.044; PMid:15921752

25. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH et al. (1998). Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 41(5): 778-799. https://doi.org/10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V; PMid:9588729

26. Martini A, Ravelli A, Avcin T, Beresford MW, Burgos-Vargas R, Cuttica R et al. (2019). Toward new classification criteria for juvenile idiopathic arthritis: first steps, pediatric rheumatology international trials organization international consensus. J Rheumatol. 46(2): 190-197. https://doi.org/10.3899/jrheum.180168; PMid:30275259

27. Minden K, Heinz C, Edelsten C, Heiligenhaus A. (2013). Review of the year: epidemiology of juvenile idiopathic arthritis and its associated uveitis: the probable risk factors. Ocul Immunol Inflamm. 21: 180-191. https://doi.org/10.3109/09273948.2013.791701; PMid:23713827

28. Minden K, Mingels A, Niewerth M, Heiligenhaus A, Ganser G. (2007, Jun). Juvenile idiopathic arthritis and uveitis: epidemiology including data from a national database. Klin Monbl Augenheilkd. 224(6): 469-472. https://doi.org/10.1055/s-2007-963288; PMid:17594614

29. Munoz-Femändez S, Martin-Mola E. (2006). Uveitis. Best Pract Res Clin Rheumatol. 20: 487-505. https://doi.org/10.1016/j.berh.2006.03.008; PMid:16777578

30. Nagpal A, Leigh JF, Acharya NR. (2008). Epidemiology of uveitis in children. Int Ophthalmol Clin. 48(3): 1-7. https://doi.org/10.1097/IIO.0b013e31817d740e; PMid:18645395

31. Oshlyanska OA, Melanchuk NA. (2019). Features of physical development in children with juvenile idiopathic arthritis. Ukrainian Journal of Rheumatology. 76(2): 52-57.

32. Ozdal PC, Sen E, Yazici A, Ozturk F. (2012). Patterns of childhood-onset uveitis in a referral center in Turkey. J Ophthalmic Inflamm Infect. 2(1): 13-19. https://doi.org/10.1007/s12348-011-0044-8; PMid:22002621 PMCid:PMC3303000

33. Päivönsalo-Hietanen T, Tuominen J, Matti Saari K. (2001). Uveitis in children: Population-based study in Finland. Acta Ophthalmologica Scandinavica. 78(1). https://doi.org/10.1034/j.1600-0420.2000.078001084.x; PMid:10726797

34. Petty RE, Rosenbaum JT. (2016). Uveitis in juvenile idiopathic arthritis. In: Petty R.E., Laxer R.M., Lindsley C.B., Wedderburn L.R. Textbook of pediatric rheumatology. 7th edn., Elsevier: 305-314. https://doi.org/10.1016/B978-1-4160-6581-4.10020-2

35. Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P et al. (1998). Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol. 25(10): 1991-1994.

36. Rosenberg KD, Feuer WJ, Davis JL. (2004). Ocular complications of pediatric uveitis. Ophthalmology. 111(12): 2299-2306. https://doi.org/10.1016/j.ophtha.2004.06.014; PMid:15582090

37. Sabri K, Saurenmann RK, Silverman ED, Levin AV. (2008). Course, complications, and outcome of juvenile arthritis-related uveitis. JAAPOS. 12(6):539-545. https://doi.org/10.1016/j.jaapos.2008.03.007; PMid:18789737

38. Shevchenko NS, Bogmat LF et al. (2020). Inflammation of the organ of vision as a comorbid condition in juvenile idiopathic arthritis. Ukrainian Journal of Rheumatology. 79(1). https://doi.org/10.32471/rheumatology.2707-6970.79.14813

39. Shin Y, Kang JM, Lee J, Lee CS, Lee SC, Ahn JG. (2021, Apr 1). Epidemiology of pediatric uveitis and associated systemic diseases. Pediatr Rheumatol Online J. 19(1): 48. https://doi.org/10.1186/s12969-021-00516-2; PMid:33794945 PMCid:PMC8015176

40. Smith JA, Mackensen F, Sen HN, Leigh JF, Watkins AS, Pyatetsky D et al. (2009). Epidemiology and course of disease in childhood uveitis. Ophthalmology. 116(8): 1544-1551, 1551.e1. https://doi.org/10.1016/j.ophtha.2009.05.002; PMid:19651312 PMCid:PMC2937251

41. Yu HH, Chen PC, Wang LC, Lee JH, Lin YT, Yang YH et al. (2013). Juvenile idiopathic arthritis-associated uveitis: a nationwide population-based study in Taiwan. Plos One. 8(8): e70625. https://doi.org/10.1371/journal.pone.0070625; PMid:23940609 PMCid:PMC3734244

42. Zbytneva SV. (2010). Morbidity in Ukraine on eye disease and its adnexa. Bulletin of Social Hygiene and Health Protection Organization of Ukraine. 3: 14-18.