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. 2024 Jul 1;7(7):e2419366.
doi: 10.1001/jamanetworkopen.2024.19366.

Cataract Development Among Pediatric Patients With Uveitis

Alan Y Hsu  1 , Hou-Ting Kuo  1   2 , Chun-Ju Lin  1   3   4 , Ning-Yi Hsia  1   3   4 , Shu-Chun Kuo  5   6 , Chang-Ching Wei  3   7 , Chun-Ting Lai  1   3   4 , Huan-Sheng Chen  8 , Yu-Hsun Wang  9 , James Cheng-Chung Wei  9   10   11   12 , Yi-Yu Tsai  1   3   4
Affiliations

Cataract Development Among Pediatric Patients With Uveitis

Alan Y Hsu et al. JAMA Netw Open. .

Abstract

Importance: The long-term estimated risk of development of cataracts among pediatric patients with uveitis is not clear.

Objective: To describe factors associated with the development of cataracts among pediatric patients with uveitis.

Design, setting, and participants: This cohort study used the international TriNetX database to enroll pediatric patients with and without uveitis from January 1, 2002, to December 31, 2022. The nonuveitis cohort consisted of randomly selected control patients matched by age, sex, race and ethnicity, and specific comorbidities.

Exposure: Diagnosis of uveitis, identified using diagnostic codes.

Main outcomes and measures: The primary outcome was the risk of developing cataracts among the uveitis group compared with the nonuveitis comparison group, with hazard ratios (HRs) and 95% CIs reported.

Results: A total of 22 687 pediatric patients with uveitis (mean [SD] age, 10.3 [5.6] years; 54.2% male) and 22 687 comparators without uveitis (mean [SD] age, 10.3 [5.6] years; 54.5% male) were enrolled in the study. The risk of cataracts was increased among pediatric patients with uveitis up to a follow-up duration of 20 years (HR, 17.17; 95%CI, 12.90-22.80) from the index date. Subgroup analyses revealed an elevated cataract risk across age groups: 0 to 6 years (HR, 19.09; 95% CI, 10.10-36.00), 7 to 12 years (HR, 27.16; 95% CI, 15.59-47.20), and 13 to 18 years (HR, 13.39; 95% CI, 8.84-20.30); both female sex (HR, 13.76; 95% CI, 9.60-19.71) and male sex (HR, 11.97; 95% CI, 8.47-16.91); and 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) race. Furthermore, increased cataract risks were also observed among those with and without a history of immunosuppressive agents (with: HR, 26.52 [95% CI, 16.75-41.90]; without: HR, 17.69 [95% CI: 11.39-27.40]), a history of 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]).

Conclusions and relevance: In this cohort study of pediatric patients with uveitis, an elevated risk of cataracts following a uveitis diagnosis was found compared with pediatric patients without uveitis. The findings suggest that pediatric patients with uveitis should be monitored for cataract development.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Patient Flow Diagram
aCataract diagnosis Q12.0, H25-H28 based on the International Statistical Classification of Diseases, Tenth Revision, Clinical Modification.
Figure 2.
Figure 2.. Kaplan-Meier Analysis for Risk of Cataract by Assessment Time
See Table 3 for hazard ratios (95% CIs) for risk of cataracts among patients with uveitis compared with those without uveitis.
See this image and copyright information in PMC

References

    1. Gilbert C, Foster A. Childhood blindness in the context of VISION 2020—the right to sight. Bull World Health Organ. 2001;79(3):227-232. - PMC - PubMed
    1. Minkus CL, Pistilli M, Dreger KA, et al. ; Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study Research Group . Risk of cataract in intermediate uveitis. Am J Ophthalmol. 2021;229:200-209. doi:10.1016/j.ajo.2021.02.032 - DOI - PMC - PubMed
    1. Chan AW, Ho YS, Chung SK, Chung SS. Synergistic effect of osmotic and oxidative stress in slow-developing cataract formation. Exp Eye Res. 2008;87(5):454-461. doi:10.1016/j.exer.2008.08.001 - DOI - PubMed
    1. Jobling AI, Augusteyn RC. What causes steroid cataracts? a review of steroid-induced posterior subcapsular cataracts. Clin Exp Optom. 2002;85(2):61-75. doi:10.1111/j.1444-0938.2002.tb03011.x - DOI - PubMed
    1. Mohammadpour M, Jafarinasab MR, Javadi MA. Outcomes of acute postoperative inflammation after cataract surgery. Eur J Ophthalmol. 2007;17(1):20-28. doi:10.1177/112067210701700104 - DOI - PubMed