Management Pearls in Pediatric Uveitis
Erin D. Stahl; Virginia Utz; Stefanie L. Davidson; Sheila Angeles-Han
Children’s Mercy Hospital
Kansas City, MO
Purpose/Relevance: Increased understanding of the timing of medical and surgical uveitis management in the pediatric ophthalmology community is needed to prevent severe complications and vision loss. The purpose of this course is to provide an updated framework for management of children with uveitis.
Target Audience: Pediatric ophthalmologists
Current Practice: Pediatric ophthalmologists are uncertain as to the timing and appropriateness of systemic treatment in pediatric uveitis. Optimal communication does not always exist between the ophthalmologist and rheumatologist. This often leads to poor control of ocular inflammation leading to ocular damage as well as steroid-related toxicity.
Best Practice: Ideal management of pediatric uveitis includes timely diagnosis, identification of underlying etiology, and implementation of appropriate steroid-sparing medications for persistent inflammation and/or inability to taper topical steroids. Systemic immunosuppression is slowly tapered after inactive disease with close monitoring and coordination of care with rheumatology. In most cases, vision-threatening complications can be avoided when the disease is aggressively treated and closely monitored.
Expected Outcomes: Clinicians will develop an evidence-based approach to the work-up and management of pediatric uveitis patients including 1) diagnostic evaluation 2) treatment algorithm that focuses on timely initiation and duration, 3) overview of common biologic agents for uveitis, 4) updates on treatment of refractory disease 5) surgical management.
Format: Didactic lecture with case presentations, panel discussion
Summary: This workshop will provide an update on current practice patterns in pediatric uveitis. Participants will leave the session with tools to aid with diagnosis and treatment of uveitis including timing and duration of biologic therapy.
References: Angeles-Han ST, Rabinovich CE. Uveitis in children. Curr Opin Rheumatol. 2016 Sep;28(5):544-9