Noninfectious Uveitis in Pediatric Rheumatology: Long-term Follow-up at Tertiary Centers.

Abstract

Objectives: Our study aimed to identify potential predictors for additional systemic involvement in patients with noninfectious uveitis, specifically focusing on their demographic, etiological, clinical, and laboratory data features from the pediatric rheumatology perspective.

Methods: Patients with noninfectious uveitis before the age of 18 years and followed up for at least 3 months in 2 tertiary centers of pediatric rheumatology and ophthalmology departments were included in the study. Demographics, etiology, clinical features, laboratory data, and treatments administered were evaluated and compared based on the etiology (idiopathic and systemic disease-related uveitis [SD-U]) and the use of biologic disease-modifying antirheumatic drugs.

Results: Of 244 patients (131 with idiopathic uveitis and 113 with SD-U), 141 (57.8%) were female. The median (min-max) age at uveitis diagnosis was 8 (1-17) years, with a median (min-max) follow-up period of 36 (3-216) months. We observed that uveitis was mostly anterior (n = 140, 57.4%), chronic (n = 122, 67.4%), and bilateral (n = 146, 59.8%). Patients with SD-U showed a higher prevalence of female predominance, younger age at diagnosis, bilateral involvement, chronic course, increased erythrocyte sedimentation rate value, and antinuclear antibody positivity compared with patients with idiopathic uveitis (p < 0.05). Uveitis-related complications occurred in 105 (43%) patients, with the most common being posterior synechiae (n = 60, 24.6%). Ocular surgery was required for 7 patients (5.3%) in idiopathic uveitis and for 14 patients (12.4%) in SD-U group.

Conclusion: Our study demonstrated that the antinuclear antibody positivity and the high erythrocyte sedimentation rate values were identified as significant, independent predictors for SD-U in patients referred with noninfectious uveitis.