Abstract
Purpose :
There is lack of population data in the rate of remission of chronic non-infectious childhood uveitis. We performed a retrospective cohort study of incident cases of childhood uveitis in a large integrated health care delivery system and assessed predictors of drug free remission
Methods :
Incident cases of all subtypes of uveitis identified by diagnosis codes in patients age 16 or younger between 2010-2020 were identified in Kaiser Permanente Northern California. Cases were excluded if the cause were infection, trauma, or postoperative, if there was a prior history of uveitis, did not require treatment and if there was lack of coverage or followup. Baseline clinical characteristics recorded included age, sex, visual acuity, laterality, racial/ethnic group, location of uveitis, posterior synechiae, cataract, cystoid macular edema, keratic precipitates, epiretinal membrane, band keratopathy, optic disc edema, and associated systemic autoimmune disease. The primary outcome ‘remission’ was defined as lack of clinical activity ≥6 months beyond the cessation of drug effect after the last medication administration, and was validated via structured health record review in chronic uveitis cases. Predictors of remission were evaluated using survival analysis and multivariate Cox proportional hazard regression modeling.
Results :
277 incident noninfectious uveitis cases met selection criteria including 145 chronic and 132 acute cases. Chronic cases included 70 (48.3%) males and 102 (73.3%) anterior cases, with median age at initial treatment of 10 (IQR 6-14) years. Median follow-up in chronic cases was 33 (IQR 15-59) months and the incidence of remission was 1.1/100-person-months. Nearly 50% of chronic cases with ≥5 years follow-up achieved remission. Adjusting for patient characteristics, male sex and older age were more likely to achieve remission (male: aHR1.85, 95%CI 1.11-3.08, P=0.019; age: aHR 1.18, 95%CI 1.10-1.28, P<.0001)
Conclusions :
Male gender and older age predicted drug free remission of chronic non-infectious childhood uveitis in this large, community-based study
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.