Demography in Swiss paediatric uveitis: a retrospective cohort study.

Abstract

Introduction: Paediatric uveitis is a rare disease. It can affect any segment and have various etiologies, including infectious, autoimmune, and masquerade diseases. The pupose of this study is to analyse and present the demographic data in paediatric uveitis in a Swiss cohort. Knowledge of local demography may guide targeted work up and treatment.

Methods: Single center retrospective study from January 2012 to June 2022. Patients under 18 years of age with uveitis were eligible for inclusion. Demographics (age at first presentation, sex), ocular signs (affected eye segment, laterality, visual acuity; VA, Snellen, decimal, clinical course), and systemic finding were analysed. Frequencies and descriptive statistics were computed, non-parametric tests and odds ratio were applied for sample comparisons. Local ethics committee approved this study.

Results: Data from 93 of 133 identified patients were available. 51% were female, mean age at first presentation was 12 years, 60% had bilateral disease. 68% were of non-infectious etiology. Most common identified etiology was toxoplasmosis (20%), followed by JIA (8%) and herpetic (8%). No associated infectious cause or systemic disease was found in 44% of the cases. Most presented with anterior uveitis (50%), followed by posterior (28%), intermediate (20%), and panuveitis (2%). 80% of anterior uveitis were non-infectious; 81% of posterior uveitis were infectious. Bilateral disease was strongly associated with non-infectious uveitis (93%), whereas unilateral disease was more likely to be of an infectious cause (70%); odds ratio = 31. Mean VA of affected eyes at first presentation was 0.79. VA was significantly worse in cases with infectious uveitis compared to non-infectious uveitis (p = 0.007). Nearly a third of affected eyes showed at least one complication. This did not differ between in non-infectious and infectious uveitis cases.

Conclusion: Bilateral disease is strongly suggestive of non-infectious uveitis. Unilateral and posterior disease is suggestive of an infectious cause, with toxoplasmosis being the most often diagnosed cause of uveitis in this cohort. Knowledge of demography is important for specialists to target workup and introduce treatment.