High-dose intravenous methylprednisolone in juvenile non-infectious uveitis: A retrospective analysis

Clin Immunol. 2020 Feb:211:108327. doi: 10.1016/j.clim.2019.108327. Epub 2019 Dec 18.

Abstract

Non-infectious uveitis is associated with visual impairment and blindness. Non-biologic treatment for non-infectious uveitis is not based on strong evidence. A retrospective chart review was conducted to investigate treatment response to high-dose intravenous methylprednisolone (IVMP) in children with non-infectious uveitis. Fifty-six patients (93 eyes affected) were included. In 29% uveitis was associated with juvenile idiopathic arthritis. Uveitis predominately affected the anterior segment, was bilateral and recurrent. Complications were common and included visual loss, synechiae, cataract and/or retinal lesions. Patients received up to 5 IVMP at monthly intervals. Visual acuity improved at 3 and 6 months. Anterior chamber cells, synechiae, keratic precipitates, papillary and/or macular edema improved at 3 months. Children treated with ≥3 IVMP (vs 1 IVMP) experienced trends towards fewer relapses, fewer cataracts and less frequently required treatment with biologic agents. High-dose IVMP induce rapid improvement in children with non-infectious uveitis. Prospective randomized trials are required to confirm results.

Keywords: Childhood; Corticosteroid; Juvenile; Methylprednisolone; Ocular inflammation; Treatment; Uveitis.

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use*
  • Arthritis, Juvenile / drug therapy
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Methylprednisolone / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome
  • Uveitis / drug therapy*

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Methylprednisolone