Children with uveitis who are treated early with systemic immunosuppression therapies may be at a lower odds of having ophthalmic surgery, a study in the British Journal of Ophthalmology suggests.

A team of researchers from Canada and the United States conducted a retrospective review of 48 children with non-infectious uveitis who were assessed between 1998 and 2013. They divided the patients into two groups: uveitis diagnosed before December 2008 (group one) and after January 2009 (group two). The researchers considered how long it took from a uveitis diagnosis to treatment with methotrexate and biologic therapy. They also looked at topical corticosteroid use more than three times a day and the presence of active uveitis cells over a three-year period during follow-up.

The researchers found methotrexate therapy was initiated at 28.9±11.8 weeks in group one, but at 14.2±10.0 weeks for group two. In addition, a biologic was added to therapy around week 134 (±46) in group one and around week 82 (±43) in group two. In group one, the study reported 69.5% of patients required one or more ophthalmic surgeries at the 3.5-year mark compared with just 26.9% in group two. As far as treatment, researchers noted methotrexate initiation within six months of uveitis onset and biological addition within 18 months reduced the need of ophthalmic surgery at the 3.5-year mark.

Also of note: investigators reported corticosteroid use of more than three times a day was seen at approximately 85.9 weeks in group one and about 14.6 weeks in group two.

Cheung CSY, Mireskandari K, Ali A, et al. Earlier use of systemic immunosuppression is associated with fewer ophthalmic surgeries in paediatric non-infectious uveitis. Br J Ophthalmol. October 11, 2019. [Epub ahead of print].