Areas of agreement in the management of childhood non-infectious chronic anterior uveitis in the UK. Issue 1 (2nd May 2019)

• Record Type: Journal Article
• Authors: Solebo, Ameenat Lola; Rahi, Jugnoo S; Dick, Andrew D; Ramanan, Athimalaipet V; Ashworth, Jane; Edelsten, Clive
• Other Names: author non-byline.; McLoone Eibhlin author non-byline.; Choi Jessy author non-byline.; Clarke Michael P author non-byline.; Denniston Alastair K author non-byline.; Petrushkin Harry author non-byline.; Watts Patrick author non-byline.; Mahmood Usman author non-byline.; Muthusamy Brinda author non-byline.; Abbott Joe author non-byline.; Pradeep Archana author non-byline.; Lambley Rosemary author non-byline.; Tambe Katya author non-byline.; Hughes Ed author non-byline.; Lee Richard WJ author non-byline.; Ritchie Ailsa E author non-byline.; Steeples Laura author non-byline.; Jones Nicholas author non-byline.; Guly Catherine author non-byline.; Thomas Dhanes author non-byline.; Sharma Srilakshmi M author non-byline.; Stanford Miles author non-byline.; Damato Erika author non-byline.; Graham Elizabeth author non-byline.
• Is Part Of: British journal of ophthalmology. Volume 104:Issue 1(2020)
• Page Start: 11
• Page End: 16
• Publication Date: 2019-05-02
• Subjects: delphi technique -- uveitis -- child -- disease management; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2018-313789
• Languages: English
• ISSNs: 0007-1161

Abstract

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.