Zamani Raha, Tahghighi Sharabian Fatemeh, Zamani Khorasgani Alireza, Zarei Mohammad, Ziaee Vahid
Department of Pediatrics, Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran.
Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Ocul Immunol Inflamm. 2025 Jul 17:1-9. doi: 10.1080/09273948.2025.2522297.
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.
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.
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).
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.
本研究旨在确定转诊至三级儿科风湿病诊所的一组伊朗儿童葡萄膜炎的模式和危险因素。
对转诊至三级儿科风湿病诊所的所有病因的葡萄膜炎患者的病历进行回顾性分析，并将随后的青少年型贝赫切特病和青少年特发性关节炎（JIA）病例作为对照。
葡萄膜炎的病因包括JIA（n = 24）、贝赫切特病（n = 15）、特发性葡萄膜炎（n = 14）、结节病/布劳综合征（n = 3）、系统性红斑狼疮（n = 2）和反应性关节炎（n = 1）。前葡萄膜炎和全葡萄膜炎是最常见的解剖亚型。28.8%的患者发现视网膜血管炎，57.6%的患者患有双侧葡萄膜炎。32%的病例出现并发症，23%的患者持续视力损害，无一例法定失明。“葡萄膜炎发病时间”的中位数从少关节型JIA的1年到多关节型组的6.5年不等，累积患病率无显著差异。持续性/复发性葡萄膜炎的危险因素是葡萄膜炎发病时年龄较小（P = 0.010）和视网膜血管炎（P = 0.049）。
本研究呈现了不同病因组葡萄膜炎的独特模式，并描述了三种罕见的葡萄膜炎病因。JIA相关葡萄膜炎在多关节型组有晚发高峰。本研究补充了现有关于儿科风湿性疾病中葡萄膜炎长期筛查和早期治疗重要性的证据。
