Incidence, sociodemographic and presenting clinical features of childhood non-infectious uveitis: findings from the UK national inception cohort study

Abstract

Background: We aimed to provide, through the Uveitis in Childhood National Cohort Study, population-based evidence on incidence, distribution and disease characteristics for childhood onset non-infectious uveitis.

Methods: Eligible children and young people (<18 years) were those newly diagnosed with non-infectious uveitis between 1 March 2020 and 28 February 2023. Cases were identified and recruited through passive surveillance across a multicentre network. Descriptive analysis of demographic, socioeconomic and clinical characteristics at diagnosis is reported alongside incidence rates, relative rates by region and sociodemographic patterning.

Results: 468 cases were identified, providing a minimal national disease incidence of 1.89/100 000 (95% CI 1.72 to 2.07). Among the 255 children recruited, anterior uveitis was predominant (76.9%) and 65% of cases were bilateral. Peak incidence was at 11-15 years. Children resident in deprived areas and those from non-White ethnic backgrounds were over-represented (28% and 31% of the cohort). One in seven children (15%) had a diagnosis of juvenile idiopathic arthritis (JIA), and 5% had tubulointerstitial nephritis. Although bilaterally poor vision was uncommon (16.8%), 44.3% had lost some vision in at least one eye.

Conclusions: There is a need to reconsider how best to deliver paediatric rheumatological and eye care that meets the needs of young people, as well as young children, with uveitis. The predominance of non-JIA-related uveitis calls for a shift in focus. There appears to be socioeconomic drivers of disease risk, which are worthy of future exploration and which have implications on the delivery of care for this chronic and blinding disease.

Keywords: Child health (paediatrics); Epidemiology; Uveitis.

Figure 1. Uveitis in Childhood National Cohort Study participant flow from identification to data collection. Due to COVID-related research pauses, only four of the centres were returning case identification data at the start of the study (March 2020).

Figure 2. Geographic distribution of cases by incidence per population aged <18 years.

Figure 3. Age at diagnosis of uveitis for whole cohort (3A) and by uveitis type.