E068 Paediatric uveitis - is there sight at the end of the tunnel?

Background/Aims Paediatric uveitis is a rare autoimmune condition affecting approximately 1 in 100,000 children. It requires long-term immunosuppressive therapy and joint management by ophthalmology and paediatric rheumatology teams. The disease often presents quietly and, combined with the challenges of examining young children, diagnosis can be delayed. Delays in referral from District General Hospitals (DGH) ophthalmology services may exacerbate disease burden, potentially impacting vision and quality of life. This study aims to characterise the disease burden in a cohort of paediatric uveitis patients, assessing the impact on both patients and National Health Service (NHS) services in ophthalmology and rheumatology. Methods Retrospective clinical cohort study. Results Our paediatric uveitis cohort comprises 61 patients: 34 with non-juvenile idiopathic arthritis (JIA)-related uveitis, 26 with JIA-associated uveitis, and 1 with post-infectious uveitis. Notably, three patients initially presented with uveitis before developing JIA. At diagnosis, 22 patients (36%) were not graded using the Standardization of Uveitis Nomenclature (SUN) criteria, complicating severity assessment. Of the 61 patients, 8 patients (13%) have transitioned to adult services for ongoing care. Among the 34 idiopathic uveitis patients, 10 were trialled off medication and 6 relapsed; 3 only required eye drops as treatment. In the JIA uveitis cohort of 26 patients, 5 were trialled off medication, 2 relapsed with uveitis, 2 with arthritis and 1 remains in remission. The mean duration of treatment for the patients who achieved remission was 3.8 years and 6 years for the rest in the JIA uveitis group. The mean treatment duration before discharge for idiopathic cases using immunosuppression was 6.2 years; no patients with JIA-related uveitis were discharged from the service. Conclusion Paediatric uveitis remains a challenge to successfully treat; the length of treatment is long, adding to the disease burden of both the patient and the NHS. Discharge is rare and patients often require transition to adult services for ongoing treatment, adding to an ever-growing adult workload. More education is needed for non-tertiary centres such as DGH to be able to accurately grade severity and refer in a timely manner for escalation of treatment. In the future, it would be helpful to identify a biomarker that predicts severity of disease and length of treatment in patients with uveitis. Disclosure M. Chatten: None. N. Pai: None. I. Nengroo: None. H. O’donnel: None. S. Rangaraj: None. A. Pradeep: None.