Idiopathic Chronic Anterior Uveitis Patients Experience Frequent Complications

Ophthalmology: uveitis. A red watery iris in a young woman with inflammation caused by uveitis.
Patients can maintain long-term visual health with adequate therapy.

Vision-threatening ocular complications are more common in children with idiopathic chronic anterior uveitis (iCAU) than those with juvenile idiopathic arthritis-associated uveitis (JIA-U), according to research published in the American Journal of Ophthalmology.

Researchers conducted a retrospective cohort study to examine the clinical course and outcome in children with iCAU compared with those in children with JIA-U. They used medical records data regarding ocular complications, visual acuity, and systemic treatment for the 2 patient groups, which were matched for age and year of uveitis diagnosis. 

The study period ranged from 1997 to 2020 and included patients diagnosed with uveitis before 16 years of age who had a minimum follow up of 6 months. 

The iCAU group included 48 patients (71% girls and 29% boys) with 83 affected eyes, and the JIA-U group included 48 patients (69% girls and 31% boys) with 73 affected eyes. Both groups of patients had a median age at uveitis diagnosis of 7.8 years. The median follow-up time was 5.0 years (IQR 2.5-8.4) in the iCAU group and 6.1 years (IQR 3.5-9.0) in the JIA-U group.

Using multivariate analyses, the researchers found that iCAU was associated with a higher prevalence of posterior synechiae (adjusted hazard rate [aHR], 3.63; P <.001) and cataract surgery (aHR, 2.90; P =.006). They observed that baseline visual acuity was worse in the iCAU group compared with the JIA-U group (20/25 vs 20/20; P <.001). 

At 5 years, the team found that visual acuity improved in the iCAU group (20/25 vs 20/20; P =.052). They also found that younger children with iCAU (≤8 years of age at diagnosis) had a higher prevalence of posterior synechiae (aHR, 2.56; P =.007), secondary glaucoma (aHR, 16.0; P=.020), and cataract surgery (aHR, 4.79; P =.004) compared with older children with iCAU (at least 9 years old at diagnosis).

“Vision-threatening ocular complications are more common in children with iCAU compared to children with JIA-U, particularly in cases in which the onset of uveitis occurred at ≤8 years of age. However, the long-term vision of these children can be improved with adequate treatment,” researchers explain.

Limitations of the study included the retrospective design, inability to analyze data regarding topical corticosteroids due to missing values, and statistical challenges to compare the groups.


Kouwenberg CV, Wennink RAW, Shahabi M, Bozkir I, Ayuso V K-K, de Boer JH. Clinical course and outcome in pediatric idiopathic chronic anterior uveitis. Am J Ophthalmol. Published online May 2, 2022. doi:10.1016/j.ajo.2022.04.015