Uveitis in Children Linked to Higher Cataract Risk

TOPLINE:

Pediatric patients with uveitis are significantly more likely to develop cataracts than those without the eye inflammation. The increased risk remains consistent across different follow-up periods and across various age, sex, and racial subgroups.

METHODOLOGY:

• Researchers conducted a cohort study using the TriNetX database, enrolling children with and without uveitis from January 1, 2002, to December 31, 2022.
• A total of 22,687 children with uveitis (mean age, 10.3 years; 45.3% women) were propensity score-matched on the basis of age, sex, race, ethnicity, and specific comorbidities to an equal number of individuals without uveitis.
• The analysis included various follow-up durations up to 20 years.
• The primary outcome was the risk of developing cataracts among those with uveitis compared with that among those without the condition.

TAKEAWAY:

• Children with uveitis had a significantly increased risk of developing cataracts, which persisted even at the 20-year follow-up of the first event of eye inflammation (hazard ratio [HR], 17.17; 95% CI, 12.90-22.80).
• Subgroup analyses revealed elevated cataract risk across age groups, sex, and race, with HRs ranging from 10.41 to 27.16.
• Patients with uveitis who did not receive steroid eye drops showed a lower risk of developing cataracts (HR, 16.49; 95% CI, 11.92-22.70) than those who received the treatment (HR, 29.51; 95% CI, 14.56-59.70).
• Increased risks for cataracts also were observed among patients with and without a history of using immunosuppressive agents and intraocular procedures.
• Compared with children without uveitis, those with the eye condition had an increased risk for cataracts whether they received steroidal immunosuppressants within 3 months after the first episode of eye inflammation (HR, 5.62; 95% CI, 4.38-7.20) or did not receive them (HR, 20.12; 95% CI, 6.31-64.17).

IN PRACTICE:

"Our findings are of importance, as cataracts can significantly impact vision and may lead to eventual blindness if not promptly diagnosed and treated," the authors of the study wrote.

SOURCE:

The study was led by Alan Y. Hsu, MD, of China Medical University Hospital in Taichung City, Taiwan. It was published online on July 1, 2024, in JAMA Network Open.

LIMITATIONS:

The study's reliance on the retrospective analysis of healthcare-related diagnostic codes limited the ability to assess the severity of cataracts. The regional coverage of the TriNetX platform, primarily focusing on the US network, restricted the generalizability of findings to other races and ethnicities. Medication nonadherence among pediatric patients could have affected the findings, potentially leading to an overestimation of cataract risks.

DISCLOSURES:

Funding sources were not disclosed for this study. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.