Patterns and Outcomes of Childhood Non-Infectious Uveitis: A Retrospective Cohort and Review of Literature.

PURPOSE

This study aims to identify the patterns and risk factors of uveitis in a cohort of Iranian children referred to a tertiary pediatric rheumatology clinic.

METHOD

A retrospective analysis was performed using the medical records of all patients with uveitis of any cause who were referred to a tertiary pediatric rheumatology clinic, along with subsequent juvenile-onset Behçet's disease and juvenile idiopathic arthritis (JIA) cases as controls.

RESULTS

Causes of uveitis included JIA ( = 24), Behçet's disease ( = 15), idiopathic uveitis ( = 14), Sarcoidosis/Blau syndrome ( = 3), systemic lupus erythematosus ( = 2) and reactive arthritis ( = 1). Anterior and panuveitis were the most common anatomical subtypes. Retinal vasculitis was found in 28.8% of patients and 57.6% had bilateral uveitis. Complications occurred in 32% of cases, persistent visual impairment in 23% and legal blindness in none. The median "time-to-uveitis" ranged from 1 year in oligoarticular JIA to 6.5 years in the polyarticular group, with no significant difference in cumulative prevalence. Risk factors of persistent/recurrent uveitis were a lower age at onset of uveitis ( = 0.010) and retinal vasculitis ( = 0.049).

CONCLUSIONS

This study presents a distinct pattern of uveitis among different etiological groups and describes three rare causes of uveitis. JIA-associated uveitis has a late-onset peak in the polyarticular group. This study adds to the existing evidence on the importance of long-term screening for uveitis and early treatment in pediatric rheumatic diseases.