J Korean Med Sci.  2022 Dec;37(49):e344. 10.3346/jkms.2022.37.e344.

Incidence and Prevalence of Pediatric Noninfectious Uveitis in Korea: A Population-Based Study

Affiliations
  • 1Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, Korea
  • 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
  • 3Seoul On Eye Clinic, Seoul, Korea
  • 4Genome Insight, Inc., San Diego, CA, USA

Abstract

Background
Uveitis is less common in children than in adults; however, pediatric uveitis has a relatively severe disease course that affects the quality of life. Although it is important to understand the epidemiological characteristics of pediatric uveitis, few studies have been conducted in large populations without referral bias. This study investigated the nationwide incidence and prevalence of pediatric uveitis in South Korea according to period, age, anatomic type, and systemic associations.
Methods
This nationwide population-based cohort study used data from the Korean National Health Insurance Service from 2002 to 2018. This study included patients younger than 19 years of age with noninfectious uveitis with at least three claims of diagnostic codes of uveitis on separate days with at least once claim of prescription codes of steroid and immunosuppressive agents. All the cases were classified as anterior or non-anterior uveitis, and the overall incidence and prevalence were estimated by age, sex, and period. Patients with noninfectious uveitis were categorized by the presence of associated systemic conditions.
Results
A total of 10,862,616 patients over 128,688,078 person-years were evaluated from 2005 to 2016. Overall, 5,368 cases of anterior uveitis and 604 cases of non-anterior uveitis were identified. The incidence and prevalence of pediatric noninfectious uveitis were 4.64 per 100,000 person-years (95% confidence interval [CI], 4.52–4.76) and 8.25 per 100,000 persons (95% CI, 8.09–8.41). Both the incidence and prevalence of pediatric uveitis increased with age. Anterior uveitis accounted for 84.7% of pediatric noninfectious uveitis prevalent cases (6.99 per 100,000 persons). Cases of juvenile idiopathic arthritis (JIA)-associated uveitis accounted for 8.7% (926 cases) of pediatric noninfectious uveitis cases with a prevalence of 0.72 per 100,000 (95% CI, 0.67–0.77). The proportion of systemic associations was higher and JIA-related uveitis accounted for 11.2% (803 cases) of recurrent or chronic noninfectious uveitis cases with a prevalence of 0.62 per 100,000.
Conclusion
This is the first population-based study investigating the largest population of pediatric patients with uveitis in Korea. The nationwide incidence and prevalence of pediatric noninfectious uveitis in 2005–2016 were 4.64 per 100,000 person-years and 8.25 per 100,000, respectively. The proportion of JIA in pediatric noninfectious uveitis was 8.7%. These population-based study findings provide a better understanding of the public health burden and aid in the planning of health-care strategies for pediatric patients with uveitis.

Keyword

Incidence; Prevalence; Uveitis; Childhood; Juvenile Idiopathic Arthritis; South Korea

Figure

  • Fig. 1 Annual incidence of pediatric noninfectious uveitis.


Reference

1. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol. 2005; 140(3):509–516. PMID: 16196117.
2. BenEzra D, Cohen E, Maftzir G. Uveitis in children and adolescents. Br J Ophthalmol. 2005; 89(4):444–448. PMID: 15774921.
3. Nagpal A, Leigh JF, Acharya NR. Epidemiology of uveitis in children. Int Ophthalmol Clin. 2008; 48(3):1–7.
4. Edelsten C, Reddy MA, Stanford MR, Graham EM. Visual loss associated with pediatric uveitis in English primary and referral centers. Am J Ophthalmol. 2003; 135(5):676–680. PMID: 12719076.
5. Rosenberg KD, Feuer WJ, Davis JL. Ocular complications of pediatric uveitis. Ophthalmology. 2004; 111(12):2299–2306. PMID: 15582090.
6. Saari KM, Päivönsalo-Hietanen T, Vaahtoranta-Lehtonen H, Tuominen J, Sillanpää M. Epidemiology of endogenous uveitis in south-western Finland. Acta Ophthalmol Scand. 1995; 73(4):345–349. PMID: 8646582.
7. Shin Y, Kang JM, Lee J, Lee CS, Lee SC, Ahn JG. Epidemiology of pediatric uveitis and associated systemic diseases. Pediatr Rheumatol Online J. 2021; 19(1):48. PMID: 33794945.
8. Rothova A, Buitenhuis HJ, Meenken C, Brinkman CJ, Linssen A, Alberts C, et al. Uveitis and systemic disease. Br J Ophthalmol. 1992; 76(3):137–141. PMID: 1540555.
9. Burns JC, Joffe L, Sargent RA, Glode MP. Anterior uveitis associated with Kawasaki syndrome. Pediatr Infect Dis. 1985; 4(3):258–261. PMID: 4039819.
10. Kim M, Kim SY. Anterior uveitis associated with Kawasaki disease-and the ophthalmologist’s role. J Korean Ophthalmol Soc. 2016; 57(2):296–301.
11. Statistics Korea. Population Census: KOSIS. Updated 2022. Accessed September 1, 2021. https://kosis.kr/common/meta_onedepth.jsp?vwcd=MT_ZTITLE&listid=A_4 .
12. Rim TH, Kim SS, Ham DI, Yu SY, Chung EJ, Lee SC, et al. Incidence and prevalence of uveitis in South Korea: a nationwide cohort study. Br J Ophthalmol. 2018; 102(1):79–83. PMID: 28596287.
13. Seepongphun U, Sittivarakul W, Dangboon W, Chotipanvithayakul R. The pattern of uveitis in a pediatric population at a tertiary center in Thailand. Ocul Immunol Inflamm. 2021.
14. Pilly B, Heath G, Tschuor P, Lightman S, Gale RP. Overview and recent developments in the medical management of paediatric uveitis. Expert Opin Pharmacother. 2013; 14(13):1787–1795. PMID: 23826652.
15. Mehta PJ, Alexander JL, Sen HN. Pediatric uveitis: new and future treatments. Curr Opin Ophthalmol. 2013; 24(5):453–462. PMID: 23872814.
16. Päivönsalo-Hietanen T, Tuominen J, Saari KM. Uveitis in children: population-based study in Finland. Acta Ophthalmol Scand. 2000; 78(1):84–88. PMID: 10726797.
17. Carvounis PE, Herman DC, Cha S, Burke JP. Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature. Graefes Arch Clin Exp Ophthalmol. 2006; 244(3):281–290. PMID: 16228217.
18. Tugal-Tutkun I. Pediatric uveitis. J Ophthalmic Vis Res. 2011; 6(4):259–269. PMID: 22454749.
19. Petty RE, Smith JR, Rosenbaum JT. Arthritis and uveitis in children. A pediatric rheumatology perspective. Am J Ophthalmol. 2003; 135(6):879–884. PMID: 12788129.
20. Thorne JE, Suhler E, Skup M, Tari S, Macaulay D, Chao J, et al. Prevalence of noninfectious uveitis in the United States: a claims-based analysis. JAMA Ophthalmol. 2016; 134(11):1237–1245. PMID: 27608193.
21. Manners PJ, Bower C. Worldwide prevalence of juvenile arthritis why does it vary so much? J Rheumatol. 2002; 29(7):1520–1530. PMID: 12136914.
22. Heiligenhaus A, Heinz C, Edelsten C, Kotaniemi K, Minden K. Review for disease of the year: epidemiology of juvenile idiopathic arthritis and its associated uveitis: the probable risk factors. Ocul Immunol Inflamm. 2013; 21(3):180–191. PMID: 23713827.
23. Keino H, Watanabe T, Taki W, Nakayama M, Nakamura T, Yan K, et al. Clinical features of uveitis in children and adolescents at a tertiary referral centre in Tokyo. Br J Ophthalmol. 2017; 101(4):406–410. PMID: 27335142.
24. Khairallah M, Attia S, Zaouali S, Yahia SB, Kahloun R, Messaoud R, et al. Pattern of childhood-onset uveitis in a referral center in Tunisia, North Africa. Ocul Immunol Inflamm. 2006; 14(4):225–231. PMID: 16911984.
25. Saurenmann RK, Rose JB, Tyrrell P, Feldman BM, Laxer RM, Schneider R, et al. Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: ethnicity as a risk factor. Arthritis Rheum. 2007; 56(6):1974–1984. PMID: 17530723.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr