The Association of Race With Childhood Uveitis

• Published in: American journal of ophthalmology Vol. 160; no. 5; pp. 919 - 928.e1
• Main Authors: Angeles-Han, Sheila T, McCracken, Courtney, Yeh, Steven, Jenkins, Kirsten, Stryker, Daneka, Travers, Curtis, Rouster-Stevens, Kelly, Vogler, Larry B, Lambert, Scott R, Drews-Botsch, Carolyn, Prahalad, Sampath
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2015; Elsevier Limited
• Subjects: Adolescent; African Americans; Age; Arthritis; Cataracts; Child; Children & youth; Continental Population Groups; Data collection; Disease; Edema; Ethnicity; Female; Follow-Up Studies; Georgia - epidemiology; Glaucoma; Health Insurance Portability & Accountability Act 1996-US; Hispanic people; Humans; Hypertension; Laboratories; Male; Ophthalmology; Pediatrics; Prevalence; Retrospective Studies; Rheumatology; Risk Factors; Sarcoidosis; Uveitis - ethnology; Visual Acuity; Georgia
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2015.08.002

Purpose To identify risk factors for a severe uveitis course among children with noninfectious uveitis. Design Retrospective cohort study. Method This was a retrospective analysis of a prospectively collected database. Records of 94 children with uveitis were reviewed at enrollment and every 3–6 months (2011–2015). Severe uveitis was defined as a history of ocular complications or a visual acuity (VA) of ≤20/200. Children were compared by disease, VA, complications, and race. Regression models were used to model risk factors for severe disease. When examining race, we focused on non-Hispanic African-American and non-Hispanic white children only. Results Of 85 children with uveitis and complete ocular examinations, 27 (32%) had a history of a VA of ≤20/200. A subanalysis of non-Hispanic African-American and white children showed an increased prevalence of VA ≤20/200 in non-Hispanic African-Americans (18/25; 72% vs 4/43; 9%). Non-Hispanic African-Americans were more likely to be diagnosed at an older age ( P  = .030) and to have intermediate uveitis ( P  = .026), bilateral disease ( P  = .032), a history of VA ≤20/50 ( P  = .002), VA ≤20/200 ( P  < .001), and a higher rate of complications ( P  < .001). On multivariable analysis, non-Hispanic African-American race was a significant predictor of blindness (OR = 31.6, 95% CI 5.9–168.5, P  < .001), after controlling for uveitis duration. Non-Hispanic African-Americans also developed 2.2 times more unique complications per year of disease than non-Hispanic whites when controlling for uveitis type and duration. Conclusions There appear to be racial differences in the outcomes of children with uveitis. Non-Hispanic African-American children with non–juvenile idiopathic arthritis–associated uveitis may have worse visual outcomes with increased vision loss and ocular complications. These findings highlight the need for future studies in minority populations.