Pediatric patients with uveitis at elevated risk of cataracts, study finds

Pediatric patients with uveitis at elevated risk of cataracts, study finds | Image Credit: © Justlight - © Justlight - stock.adobe.com.

Findings from a recent study published in JAMA Network Open suggested that pediatric patients with uveitis should be monitored for cataract development, as they were at an elevated risk compared to pediatric patients without uveitis.

"Pediatric cataracts are a significant cause of childhood blindness globally. A better understanding of the etiologies for pediatric cataracts is crucial for ensuring optimal clinical outcomes for these vulnerable patients," wrote the investigative team, led by Alan Y. Hsu, MD, Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan.

Since the long-term estimated risk of cataracts development among this population with uveitis is not clear, the investigators sought to describe the factors associated with cataract development. The cohort study design enrolled 22,687 pediatric patients aged 18 years or younger, with a mean age of 10.3 years (54.2% male). In addition, 22,687 comparators without uveitis were also enrolled, with a mean age 10.3 years as well (54.5% male).

Risk of developing cataracts among the uveitis group compared to the nonuveitis group was the primary outcome of the study, with hazard ratios (HRs) and 95% CIs reported, stated the study authors. All participants in the uveitis group were diagnosed from January 1, 2002, to December 31, 2022, based on the presence of ICD-10-CM diagnostic codes.

Risk for cataract development was assessed at specific follow-up durations of 1 year, 2 years, 5 years, and 20 years following the index date, with an increased risk of cataracts development among patients aged younger than 18 years present at each time point:

• 1-year increased risk (HR, 27.87; 95% CI, 16.64-46.60)
• 2-year increased risk (HR, 21.09; 95% CI, 14.32-31.00)
• 5-year increased risk (HR, 17.93; 95% CI, 13.08-24.50)
• 20-year increased risk (HR, 17.17; 95% CI, 12.90-22.80)

Increased risk for cataracts development was observed across all age groups in the study and for both female sex (HR, 13.76; 95% CI, 9.60-19.71) and male sex (HR, 11.97; 95% CI, 8.47- 16.91). Increased risks were observed among Asian (HR, 13.80; 95% CI, 3.28-58.07), Black or African American (HR, 10.41; 95% CI, 5.60-19.36), and White (HR, 15.82; 95% CI, 11.05-22.60) races.

In addition, increased risks were observed for patients both with (HR, 26.52 [95% CI, 16.75-41.90]) and without (HR, 17.69 [95% CI: 11.39-27.40]) a history of immunosuppressive agents, steroid eye drop use (with: HR, 29.51 [95% CI, 14.56-59.70]; without: HR, 16.49 [95% CI, 11.92-22.70]), and a history of intraocular procedures (with: HR, 11.07 [95%CI, 4.42-27.71]; without: HR, 14.49 [95% CI, 10.11-20.70]), according to study results.

"This cohort study found that pediatric patients younger than 18 years with uveitis diseases may be at a significantly increased risk for cataract development," concluded the study authors, who added, "These findings suggest that pediatric patients with uveitis should be monitored for future cataract development."

Reference:

Hsu AY, Kuo H, Lin C, et al. Cataract development among pediatric patients with uveitis. JAMA Netw Open. 2024;7(7):e2419366. doi:10.1001/jamanetworkopen.2024.19366