@article {1470998,
	title = {Earlier use of systemic immunosuppression is associated with fewer ophthalmic surgeries in paediatric non-infectious uveitis},
	journal = {Br J Ophthalmol},
	volume = {104},
	number = {7},
	year = {2020},
	month = {2020 Jul},
	pages = {938-942},
	abstract = {BACKGROUND/AIMS: There is a paucity of large trials investigating the effect of management strategies for paediatric non-infectious uveitis on complications requiring surgery. The purpose of our study is to investigate whether earlier initiation of systemic immunosuppression in paediatric non-infectious uveitis is associated with fewer ophthalmic surgeries. METHODS: A retrospective review was conducted on 48 children with non-infectious uveitis assessed in 1998-2013. Patients were divided into uveitis diagnosed before December 2008 (group 1) and after January 2009 (group 2). Duration from uveitis onset to methotrexate initiation (U-MTX) and biological addition (U-Biologic) were reviewed. Follow-up visits with topical corticosteroids \&gt;3 times daily and active uveitis (>=1+ cells) during 3.5 years were documented. The main outcome measure was the need for >=1 ophthalmic surgery at 3.5 years. RESULTS: In group 1, 69.5\% of patients required >=1 ophthalmic surgery at 3.5 years versus 26.9\% in group 2 (p=0.005). U-MTX was 28.9{\textpm}11.8 weeks and 14.2{\textpm}10.0 weeks for groups 1 and 2 (p=0.028). U-Biologic was 134.6{\textpm}46.0 weeks and 82.3{\textpm}43.3 weeks for groups 1 and 2 (p=0.0016). Corticosteroid use \&gt;3 times daily was 85.9{\textpm}52.7 weeks and 14.6{\textpm}11.1 weeks for groups 1 and 2. Multivariate regression showed methotrexate initiation within 6 months of uveitis onset lowered the likelihood of needing ophthalmic surgery at 3.5 years (OR=6.2, 95\% CI 1.2 to 33.4; p=0.033). Univariate regression demonstrated biological addition within 18 months of uveitis onset reduced the likelihood of requiring ophthalmic surgery (OR 12.57, 95\% CI 1.28 to 123.48; p=0.030). CONCLUSION: Earlier control of uveitis by addition of immunosuppressive therapy reduced the need for ophthalmic surgery.},
	issn = {1468-2079},
	doi = {10.1136/bjophthalmol-2019-314875},
	author = {Cheung, Crystal Sin Yi and Mireskandari, Kamiar and Ali, Asim and Silverman, Earl and Tehrani, Nasrin}
}
