Search

Objectives: To evaluate the clinical features of pediatric non-infectious uveitis (NIU) patients treated with adalimumab (ADA) and the efficacy of ADA in patients unresponsive to conventional immunosuppressive therapy. Materials and Methods: The records of 91 NIU patients aged ≤16 years who received ADA therapy were evaluated retrospectively. The patients’ demographic and clinical characteristics and treatment approaches were recorded. The efficacy of ADA in patients treated for at least 1 year after failure of conventional immunosuppressive treatment was evaluated by comparing the best corrected visual acuity (BCVA), severity of intraocular inflammation, uveitis flare-ups, topical and systemic corticosteroid (CS) use, and central macular thickness (CMT) values before and after ADA treatment. Results: The study included 103 eyes of 53 patients, of whom 29 (54.7%) were female. The mean age at presentation was 8.2±3.4 (range: 3-16) years. The mean follow-up period was 41.6±28.2 (range: 18-120) months. Twenty-six patients (49.0%) had anterior uveitis, 22 (41.5%) had intermediate uveitis, and 5 (9.4%) had panuveitis. The mean duration of ADA treatment was 23.0±13.7 (range: 12-60) months. Uveitis flare-ups developed in only 13 patients (24.5%) while on ADA treatment. When pre- and post-treatment periods were compared, the mean number of uveitis flare-ups, intraocular inflammation severity, mean dose of topical and systemic CS, and mean CMT values were significantly lower in the post-treatment period (p

Objectives:To report the ocular findings, laboratory results, and management of patients with tubulointerstitial nephritis and uveitis syndrome (TINU), whose numbers increased during the 2019 coronavirus disease (COVID-19) pandemic.Materials and Methods:Demographic characteristics, ophthalmic examination findings, laboratory results including polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), serum SARS-CoV-2 immunoglobulin G (IgG) antibody, and treatment of patients diagnosed with TINU between March 2020 and March 2022 were evaluated retrospectively.Results:The study included 19 eyes of 10 patients (6 female/4 male). The mean age was 13.5±2.4 years (range: 8-16 years). The mean follow-up duration was 13.5±6.1 months (range: 6-24 months). All patients presented with anterior uveitis. Anterior uveitis was bilateral in 9 patients (90%) and unilateral in 1 patient (10%). Posterior segment findings were normal in 8 patients (80%), and bilateral optic disc edema was observed in only 2 patients (20%). None of the patients had a previous SARS-CoV-2 infection and/or vaccination history. The SARS-CoV-2 PCR test was negative in all patients at presentation. The SARS-CoV-2 IgG antibody test was reactive in 7 patients (70%). Recurrent uveitis developed in 8 patients (80%) during follow-up. Systemic immunomodulatory therapy was required for the control of ocular inflammation in 7 patients (70%) with severe uveitis flare-ups.Conclusion:TINU is a multisystemic autoimmune disease, especially in response to environmental triggering factors such as viral infections. Although TINU is a rare disease, the number of cases increased during the COVID-19 pandemic. SARS-CoV-2 antibodies were detected at a significant rate of 70% in these patients, who did not have a history of SARS-CoV-2 infection and vaccination. Previous asymptomatic SARS-CoV-2 infection in children may be a triggering factor in the development of TINU.