Predictors of relapse after discontinuing systemic treatment in autoimmune chronic uveitis

Introduction Non infectious uveitis in childhood is a relatively uncommon severe disease, with potential significant long-term complications such as cataract, glaucoma and eventually blindness. For these reasons refractory uveitis usually requires early and aggressive immunosuppressive treatment in order to preserve visual acuity and to prevent the significant morbidity of chronic steroid administration. However, the lack of evidence from head-to-head randomized controlled trials (RCT) limits our understanding about the best treatment choices, as well as time of instituting therapy and its duration. Once a child with active uveitis has achieved remission on treatment, there are no evidence-based guidelines with respect to the duration of continued treatment in autoimmune child chronic uveitis. Information regarding the natural clinical history of a child on systemic treatment due to auto-immune chronic uveitis would be helpful in driving therapy: if it would be possible to identify early children at high risk to flare once systemic therapy is stopped, they could have benefits in visual acuity prognosis and quality of life, as well as time free from disease.