Macular edema (ME) is the most frequent cause of irreversible visual impairment in patients with uveitis. To date, little data exists about the clinical course of ME in pediatric patients. A retrospective, observational study was performed to examine the visual and macular thickness outcomes of ME associated with chronic, noninfectious uveitis in pediatric patients. Pediatric patients with noninfectious uveitis complicated by ME seen in the University of California San Francisco Health System from 2012 to 2018 were identified using ICD-9 and ICD-10 codes. Data were collected from medical records including demographics, diagnoses, ocular history, OCT imaging findings, complications, and treatments at first encounter and at 3, 6, 9, and 12-month follow-up visits. Cox proportional hazards regression was used to investigate the association between different classes of treatment (steroid drops, steroid injections, oral steroids and other immunosuppressive therapies) and resolution of macular edema. The cohort comprised of 21 children (26 eyes) with a mean age of 10.5 years (SD 3.3). Undifferentiated uveitis was the most common diagnosis, affecting 19 eyes (73.1%). The majority of observed macular edema was unilateral (16 patients, 76.2%) and 5 patients had bilateral macular edema. The mean duration of follow-up at UCSF was 35.3 months (SD 25.7). By 12 months, 18 eyes (69.2%) had achieved resolution of ME. The median time to resolution was 3 months (IQR 3–6 months). Median best-corrected visual acuity (BCVA) at baseline was 0.54 logMAR (Snellen 20/69, IQR 20/40 to 20/200). Median BCVA at 12 months was 0.1 logMAR (Snellen 20/25, IQR 20/20 to 20/50) Corticosteroid injections were associated with a 4.0-fold higher rate of macular edema resolution (95% CI 1.3–12.2, P = 0.01). Although only 15% of the pediatric patients with uveitis in the study cohort had ME, it is clinically important to conduct OCTs to detect ME in this population. Treatment resulted in 69% of eyes achieving resolution of ME by 12 months, accompanied with improvement in visual acuity. Corticosteroid injections were significantly associated with resolution of macular edema.

中文翻译：

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小儿黄斑水肿合并非感染性葡萄膜炎的临床结局

黄斑水肿（ME）是葡萄膜炎患者不可逆视力障碍的最常见原因。迄今为止，有关小儿ME的临床过程的数据很少。进行了一项回顾性观察研究，以检查小儿患者与慢性，非感染性葡萄膜炎相关的ME的视觉和黄斑厚度结局。使用ICD-9和ICD-10代码鉴定了2012年至2018年在加利福尼亚大学旧金山卫生系统内发现的小儿非感染性葡萄膜炎并发ME的患者。从医疗记录中收集数据，包括人口统计学，诊断，眼史，OCT影像学发现，并发症和首次相遇以及在3、6、9和12个月的随访中的治疗方法。Cox比例风险回归用于研究不同类别的治疗（类固醇滴剂，类固醇注射剂，口服类固醇和其他免疫抑制疗法）与黄斑水肿消退之间的关联。该队列由21名儿童（26眼）组成，平均年龄为10.5岁（SD 3.3）。未分化葡萄膜炎是最常见的诊断，影响19眼（73.1％）。观察到的大多数黄斑水肿为单侧（16例，占76.2％），5例患有双侧黄斑水肿。UCSF的平均随访时间为35.3个月（SD 25.7）。到12个月时，有18眼（69.2％）达到了ME的分辨率。中位解决时间为3个月（IQR 3–6个月）。基线时，最佳矫正视力中位数（BCVA）为0.54 logMAR（Snellen 20/69，IQR 20/40至20/200）。12个月时的BCVA中位数为0。1 logMAR（Snellen 20/25，IQR 20/20至20/50）皮质类固醇注射与黄斑水肿消退率高4.0倍相关（95％CI 1.3–12.2，P = 0.01）。尽管在该研究队列中只有15％的小儿葡萄膜炎患者患有ME，但在该人群中进行OCT检测ME在临床上很重要。治疗导致69％的眼睛在12个月内达到ME的分辨率，并且视力得到改善。皮质类固醇注射与黄斑水肿的消退显着相关。在这些人群中进行OCT检测以检测ME具有重要的临床意义。治疗导致69％的眼睛在12个月内达到ME的分辨率，并且视力得到改善。皮质类固醇注射与黄斑水肿的消退显着相关。在这些人群中进行OCT检测以检测ME具有重要的临床意义。治疗导致69％的眼睛在12个月内达到ME的分辨率，并且视力得到改善。皮质类固醇注射与黄斑水肿的消退显着相关。