Patterns and Outcomes of Childhood Non-Infectious Uveitis: A Retrospective Cohort and Review of Literature

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 (<i>n</i> = 24), Behçet’s disease (<i>n</i> = 15), idiopathic uveitis (<i>n</i> = 14), Sarcoidosis/Blau syndrome (<i>n</i> = 3), systemic lupus erythematosus (<i>n</i> = 2) and reactive arthritis (<i>n</i> = 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 (<i>p</i> = 0.010) and retinal vasculitis (<i>p</i> = 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. • Most common causes of pediatric non-infectious uveitis in Iranian children were JIA, Behçet’s Disease and idiopathic uveitis. • A second peak of uveitis development is observed in polyarticular JIA, 6–8 years after the disease onset • Only age at onset of JIA is a significant predictor of uveitis in multivariate analysis. • The more favorable outcome of uveitis in this study, i.e. lower rates of permanent visual impairment, despite similar rates of complications at diagnosis, could be attributed to the more frequent use of biotherapies.