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Introduction <p>This study aims to describe complications of pediatric-onset uveitis and their predictors among baseline and treatment-related factors.</p> Methods <p>This registry-based observational study included patients with noninfectious uveitis with disease onset &lt; 18&#xa0;years.</p> Results <p>A total of 309 patients were enrolled (535 eyes). Uveitis was anterior in 290 eyes (54.2%), panuveitis in 121 (22.6%), intermediate in 88 (16.4%), and posterior in 24 (4.5%). Over a median follow-up of 49.0&#xa0;months (interquartile range [IQR] 101.0), 137 children (44.3%) developed ≥ 1 complication (14.4 per 100 patient-years).</p> <p>Idiopathic uveitis (<i>p</i> &lt; 0.001), longer topical glucocorticoid (GC) monotherapy (<i>p</i> &lt; 0.001) and longer delay of immunosuppressive therapy (IST) (<i>p</i> = 0.03) were associated with a higher frequency of complications. In multivariate analysis, anterior uveitis was protective against complications (odds ratio [OR] 0.10, 95% confidence interval [CI] − 4.1 to − 1.6, <i>p</i> &lt; 0.001), whereas a chronic course of uveitis significantly increased the risk (OR 6.13, 95% CI 1.0–2.6, <i>p</i> &lt; 0.001). Older age at onset was protective against cataract (OR 0.91, 95% CI − 0.2 to − 0.02, <i>p</i> = 0.020) and band keratopathy (OR 0.8, 95% CI − 0.4 to − 0.1, <i>p</i> = 0.003).</p> <p>Final best-corrected visual acuity (BCVA) (Snellen decimals) was inversely correlated with the duration of topical GC monotherapy (<i>ρ</i> = − 0.23; <i>p</i> = 0.001). In multivariate analysis, panuveitis was linked to a 0.142 decimal reduction (95% CI − 0.219 to − 0.066, <i>p</i> &lt; 0.001), and cataract to a 0.295 reduction (95% CI − 0.372 to − 0.217, <i>p</i> &lt; 0.001) in the final BCVA.</p> Conclusions <p>Children with chronic, idiopathic, early-onset, and non-anterior uveitis are at greatest risk for complications. Structured screening for these children, along with early initiation of systemic IST, is essential to prevent visual impairment.</p>

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Incidence and Predictors of Ocular Complications in Pediatric-Onset Uveitis: Data from the AIDA Network Uveitis Registry

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  • 发表日期：

    2025年9月23日

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  • Carla Gaggiano,
  • Alejandra De-la-Torre,
  • Juanita Cardona-López,
  • Silvana Guerriero,
  • Gaafar Ragab,
  • Maria Pia Paroli,
  • Luciana Breda,
  • Emanuela Del Giudice,
  • Maria Tarsia,
  • Jurgen Sota,
  • Adele Civino,
  • Marco Cattalini,
  • Antonio Vitale,
  • Stefano Gentileschi,
  • Angela Mauro,
  • Sulaiman Al-Mayouf,
  • Soad Hashad,
  • Alex Fonollosa,
  • Shereen Hassan Aboul Naga,
  • Rana Hussein Amin,
  • Lampros Fotis,
  • Maria Francesca Gicchino,
  • Valeria Caggiano,
  • Rosanna Dammacco,
  • Maria Cristina Maggio,
  • Daniela Rodríguez-Camelo,
  • Maria Sole Chimenti,
  • Juliana Lopez-Bonilla,
  • Ezgi Deniz Batu,
  • Seza Ozen,
  • Francesca Minoia,
  • Abdurrahman Tufan,
  • Mohamed Tharwat Hegazy,
  • Kalpana Babu,
  • Jessica Sbalchiero,
  • Abdelhafeez Moshrif,
  • Patrizia Barone,
  • Perla Ayumi Kawakami-Campos,
  • Alessandro Conforti,
  • Marcello Govoni,
  • Giovanni Conti,
  • Maissa Thabet,
  • Francesco La Torre,
  • Ester Carreño,
  • Vishali Gupta,
  • Bruno Frediani,
  • Luca Cantarini,
  • Claudia Fabiani

摘要

Introduction

This study aims to describe complications of pediatric-onset uveitis and their predictors among baseline and treatment-related factors.

Methods

This registry-based observational study included patients with noninfectious uveitis with disease onset < 18 years.

Results

A total of 309 patients were enrolled (535 eyes). Uveitis was anterior in 290 eyes (54.2%), panuveitis in 121 (22.6%), intermediate in 88 (16.4%), and posterior in 24 (4.5%). Over a median follow-up of 49.0 months (interquartile range [IQR] 101.0), 137 children (44.3%) developed ≥ 1 complication (14.4 per 100 patient-years).

Idiopathic uveitis (p < 0.001), longer topical glucocorticoid (GC) monotherapy (p < 0.001) and longer delay of immunosuppressive therapy (IST) (p = 0.03) were associated with a higher frequency of complications. In multivariate analysis, anterior uveitis was protective against complications (odds ratio [OR] 0.10, 95% confidence interval [CI] − 4.1 to − 1.6, p < 0.001), whereas a chronic course of uveitis significantly increased the risk (OR 6.13, 95% CI 1.0–2.6, p < 0.001). Older age at onset was protective against cataract (OR 0.91, 95% CI − 0.2 to − 0.02, p = 0.020) and band keratopathy (OR 0.8, 95% CI − 0.4 to − 0.1, p = 0.003).

Final best-corrected visual acuity (BCVA) (Snellen decimals) was inversely correlated with the duration of topical GC monotherapy (ρ = − 0.23; p = 0.001). In multivariate analysis, panuveitis was linked to a 0.142 decimal reduction (95% CI − 0.219 to − 0.066, p < 0.001), and cataract to a 0.295 reduction (95% CI − 0.372 to − 0.217, p < 0.001) in the final BCVA.

Conclusions

Children with chronic, idiopathic, early-onset, and non-anterior uveitis are at greatest risk for complications. Structured screening for these children, along with early initiation of systemic IST, is essential to prevent visual impairment.