Epidemiologic study of pediatric uveitis and its ophthalmic complications using the Korean National Health Insurance Claim Database

Abstract

Purpose : To investigate the incidence and ophthalmic complications of pediatric uveitis using the Korean National Health Insurance (NHI) Service database, which covers nearly the entire South Korean population.

Methods : Nationwide population-based longitudinal cohort study. The index study included individuals < 18 years of age who were diagnosed with uveitis on at least three separate visits between 2010-2014. All uveitis cases were classified as either anterior or non-anterior on the basis of the diagnostic code of the Korean Classification of Diseases, 8th edition, a modified version of the International Classification of Diseases, 10th edition (ICD-10). The study used the NHI database from 2005 to 2021 and identified patients diagnosed with pediatric uveitis between 2010-2014 with a five-year wash-out period (excluding cases with previous diagnoses of uveitis between 2005-2009) to investigate the occurrence of ophthalmic complications including glaucoma, cataract, macular disease, retinal detachment, band keratopathy, and amblyopia, along with the frequency of procedures performed including glaucoma surgery, cataract surgery, and vitreoretinal surgery during the seven-year follow-up period. We also investigated the systemic and socioeconomic associations between pediatric uveitis and its ophthalmic complications.

Results : A total of 9, 495 cases of pediatric uveitis (8, 734 cases with anterior and 761 with non-anterior uveitis) were identified, with an average incidence (per 10, 000 persons) of total, anterior, and non-anterior uveitis being 2.0, 1.8, and 0.2, respectively. The most common complications were glaucoma, macular disease, and amblyopia, in decreasing order. Patients with non-anterior uveitis had a significantly higher risk of ophthalmic complications than those with anterior uveitis, with the highest HRs obtained for retinal detachment (HR, 4.80), cataract (HR, 2.98), and amblyopia (HR, 1.32).

Conclusions : The index study is the first population-based analysis of complications of pediatric uveitis. Moreover, the study findings highlight the higher risks associated with non-anterior uveitis.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.