The Association of Race With Childhood Uveitis

• Type of Material: Article
• Authors: Sheila Angeles-Han, Emory University; Courtney McCracken, Emory University; Steven Yeh, Emory University; Kirsten Jenkins, Emory University; Daneka Stryker, Emory University; Curtis Travers, Emory University; Kelly Rouster Stevens, Emory University; Larry Vogler, Emory University; Scott Lambert, Emory University; Carolyn Drews-Botsch, Emory University; Sampath Prahalad, Emory University
• Language: English
• Date: 2015-11-01
• Publisher: Elsevier Masson
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ajo.2015.08.002
• Title of Journal or Parent Work: American Journal of Ophthalmology
• ISSN: 0002-9394
• Volume: 160
• Issue: 5
• Start Page: 919
• End Page: 928
• Grant/Funding Information: This study is supported by the National Eye Institute K23-EY021760/NIH, Bethesda, Maryland (Dr. Angeles-Han). Dr. Prahalad is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases R01-AR060893/NIH, Bethesda, Maryland, The Marcus Foundation Inc. (Atlanta, Georgia), and the Arthritis Foundation (Atlanta, Georgia) but these had no role in the design or conduct of this research.
• Keywords: CHILDREN; VISUAL OUTCOMES; ANTERIOR UVEITIS; RISK-FACTORS; Life Sciences & Biomedicine; COHORT; AFRICAN-AMERICANS; Ophthalmology; RHEUMATOID-ARTHRITIS; Science & Technology; JUVENILE IDIOPATHIC ARTHRITIS; STEROID-TREATMENT
• Research Categories: Health Sciences, Opthamology; Health Sciences, Epidemiology

Abstract

Purpose: To identify risk factors for a severe uveitis course among children with non-infectious 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=0.030), have intermediate uveitis (p=0.026), bilateral disease (p=0.032), a history of VA ≤20/50 (p=0.002), VA ≤20/200 (p<0.001), and a higher rate of complications (p<0.001). On multivariable analysis, non-Hispanic African American race was a significant predictor of blindness (OR=31.6, 95% CI (5.9– 168.5), p<0.001), 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.