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Areas of agreement in the management of childhood non-infectious chronic anterior uveitis in the UK

Research output: Contribution to journalArticle

Original languageEnglish
Number of pages6
JournalBritish Journal of Ophthalmology
Early online date2 May 2019
DOIs
DateAccepted/In press - 22 Mar 2019
DateE-pub ahead of print (current) - 2 May 2019

Abstract

BACKGROUND/AIMS:
There is a paucity of high-level evidence to support the management of childhood uveitis, particularly for those children without juvenile idiopathic arthritis uveitis (JIA). We undertook a modified Delphi consensus exercise to identify agreement in the management of chronic anterior uveitis (CAU), the most common manifestation of childhood disease.

METHODS:
A four-round, two-panel process was undertaken between June and December 2017. Paediatric uveitis specialists identified through multiple sources, including a multicentre network (the Paediatric Ocular Inflammation Group), were invited to participate. They were asked whether they agreed with items derived from existing guidelines on the management of JIA-U when extrapolated to the population of all children with CAU. Consensus was defined as agreement greater than or equal to 75% of respondents.

RESULTS:
26 of the 38 (68%) invited specialists participated with the exercise, and response rates were 100% for rounds one to three, and 92% for round four. Consensus was reached on 23 of the 44 items. Items for which consensus was not reached included management at presentation, use of systemic and periocular steroids for children with severe disease and the role of conventional steroid sparing immunosuppressants beyond methotrexate.

CONCLUSION:
The areas of management uncertainty at the level of the group, as indicated by absence of consensus, reflect the areas where the evidence base is particularly poor. Our findings identify the key areas for the future research needed to ensure better outcomes for this blinding childhood ocular inflammatory disorders.

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via BMJ Publishing at https://bjo.bmj.com/content/early/2019/05/02/bjophthalmol-2018-313789 . Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 225 KB, PDF-document

    Licence: CC BY-NC-ND

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