AB1090 Analysis of a cohort of patients attending a combined ophthalmology- rheumatology clinic in a tertiary referral centrein egypt
Authors: E. Abd El Latif
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Paediatric rheumatologic diseases may have sight-threatening ocular complications including uveitis, scleritis, and retinopathy. Conversely, children presenting with uveitis, scleritis, episcleritis, or optic neuritis may have an underlying rheumatologic disease. Combined ophthalmology-rheumatology clinics can facilitate the comprehensive management of these patients. <h3>Objectives</h3> To describe the demographic characteristics, paediatric rheumatologic diseases distribution, paediatric ocular manifestations distribution, and active treatments in a combined ophthalmology- rheumatology clinic in a tertiary referral centre in Egypt. <h3>Methods</h3> We included all new patients who attended a combined ophthalmology –rheumatology clinic at a tertiary referral hospital from the 1st of October 2015 to the 30th of November 2017. We analysed their demographic, clinical, laboratory, and treatment characteristics. Patients were considered to have activity according to the joint opinion of the ophthalmic and rheumatologic consultants. <h3>Results</h3> We included 538 new patients. 331 were female (61.5%) and the median age (range) was 8.1 years (1.1–17.3). 59.5% of the patients had juvenile idiopathic arthritis (JIA), whereas patients with SLE, Behçet's disease, dermatomyositis, scleroderma, and juvenile ankylosing spondylitis represented 8.6%, 8.1%, 7.2%, 4.7%, and 4.3% of the studied cohort respectively. Of the patients with juvenile idiopathic arthritis, 56.7% had not developed ocular manifestations by the end of the study, while 27.3% suffered from uveitis that was controlled by methotrexate, 7.4% suffered from uveitis that was controlled by both methotrexate and adalimumab, and 8.6% suffered from uveitis that was still active by the end of the study period. 72.3% of the patients with Behçet's disease had uveitis, of which 34.6% suffered profound diminution of vision in the affected eye(s) despite receiving anti TNFs. Other medications that were given were prednisolone, azathioprine, cyclosporine, and cyclophosphamide. Smaller percentages of patients with dermatomyositis, scleroderma, and juvenile ankylosing spondylitis, developed ocular manifestations, and the vast majority were systemically and ophthalmologically quiescent by the end of the study duration. <h3>Conclusions</h3> More than half the patients attending the combined clinic during the period of the study had JIA. A greater percentage of patients with uveitis due to JIA could be controlled medically than of patients with uveitis due to Behçet's disease. A multidisciplinary clinic can save patients with rheumatologic diseases and uveitis precious time. <h3>References</h3> [1]Engelhard SB, Bajwa A, Reddy AK. Causes of uveitis in children without juvenile idiopathic arthritis. Clin Ophthalmol2015; 9: 1121–1128. [2] Gilles CL. Uveitis in childhood—part I. Anterior. Ann Ophthalmol1989; 21:13–19. [3] Tugal-Tutkun I, Havrlikova K, Power WJ, et al. Changing patterns in uveitis of childhood. Ophthalmology1996; 103: 375–383. [4] Rosenberg KD, Geuer WJ, Davis JL. Ocular complications of pediatric uveitis. Ophthalmology2004; 111: 2299–2306. [5] BenEzra D, Cohen E, Maftzir G. Uveitis in children and adolescents. Br J Ophthalmol. 2005;89(4):444–448. <h3>Disclosure of Interest</h3> None declared