儿童和青少年中的非传染性葡萄膜炎（NIU）是儿童视力减退的罕见但可治疗原因。儿童NIU的治疗和其副作用、失明风险以及需要长期疾病监测等问题，对年轻患者和家庭提出了重大挑战。治疗包括局部和全身治疗，本综述将着重介绍全身治疗方法，包括类固醇、传统合成疾病修饰抗风湿药物（csDMARD）和生物修饰疾病修饰抗风湿药物（bDMARD）。治疗一般按步骤计划。在儿童NIU中，甲氨蝶呤已被证实是首选的csDMARD。抗肿瘤坏死因子（TNF）剂阿达利珠单抗是唯一一种正式批准用于儿童NIU治疗的bDMARD，并具有良好的安全性和有效性。生物类似药物在儿童NIU治疗中越来越受到关注。其他在文献中有一定证据用于儿童NIU治疗的bDMARD包括英夫利昔单抗、托珠单抗、阿巴塞普、利妥昔单抗，以及最近发现的Janus激酶抑制剂。管理儿童接受这些全身治疗的重要方面包括疫苗接种问题、感染风险和心理困扰。此外，还需要制定策略来应对抗TNF治疗的原发性非反应/继发性反应丧失、药物切换和监测方案等问题。优化儿童葡萄膜炎的管理需要跨学科团队，包括专门的儿科葡萄膜炎和风湿病护士、儿科风湿病医生、心理支持、斜视和验光支持以及游戏专家。版权所有©2023 Elsevier Inc.

Non-infectious uveitis (NIU) in children and adolescents is a rare but treatable cause of visual impairment in children. Treatments for pediatric NIU and their side effects, alongside the risks of vision loss and need for long-term disease monitoring, pose significant challenges for young patients and their families. Treatment includes local and systemic approaches and this review will focus on systemic therapies that encompass corticosteroids, conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and biological disease-modifying antirheumatic drugs (bDMARD). Treatment is generally planned in a stepwise approach. Methotrexate is well-established as the preferential csDMARD in paediatric NIU. Adalimumab, an anti-tumor necrosis factor (TNF) agent, is the only bDMARD formally approved for pediatric NIU and has a good safety and efficacy profile. Biosimilars are gaining increasing visibility in the treatment of pediatric NIU. Other bDMARD with some evidence in literature for treatment of pediatric NIU include infliximab, tocilizumab, abatacept, rituximab and, more recently, Janus kinase inhibitors. Important aspects of managing children on these systemic therapies include vaccination issues, risk of infection, and psychological distress. Also, strategies need to address regarding primary non-response/secondary loss of response to anti-TNF treatment, biological switching and monitoring regimens for these drugs. Optimal management of pediatric uveitis involves a multidisciplinary team, including specialist pediatric uveitis and rheumatology nurses, pediatric rheumatologists, psychological support, orthoptic and optometry support, and play specialists.Copyright © 2023. Published by Elsevier Inc.