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Sociodemographic and Visual Outcomes of Juvenile Idiopathic Arthritis Uveitis: IRIS® Registry Study
Oliver Davidson1,2, Anand E Rajesh1,2, Marian Blazes1,2
1Department of Ophthalmology, University of Washington, Seattle, WA, USA.
Insights
Sociodemographic factors like male sex, Black race, and Medicaid insurance increase the risk of poor vision in children with juvenile idiopathic arthritis-associated uveitis. Understanding these disparities can improve care.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Background:
- Juvenile idiopathic arthritis-associated uveitis (JIA-U) is a significant cause of vision loss in children.
- Sociodemographic factors may influence visual outcomes in pediatric uveitis.
Purpose of the Study:
- To investigate the association between sociodemographic factors and poor visual outcomes in children diagnosed with JIA-U.
- To identify specific risk factors that may inform clinical practice and targeted interventions.
Main Methods:
- Retrospective cohort study of patients under 18 with JIA-U using the Intelligent Research in Sight Registry.
- Analysis of sociodemographic data, insurance status, and visual outcomes (blindness, cataract, glaucoma surgery).
- Multivariable-adjusted Cox proportional hazards models were employed to calculate hazard ratios.
Main Results:
- Higher risk of blindness (visual acuity 20/200 or worse) was observed in males (HR 2.15), Black or African American patients (HR 2.54), and Medicaid-insured patients (HR 2.23) compared to their respective counterparts.
- These associations persisted after adjusting for sociodemographic and insurance factors.
Conclusions:
- Sociodemographic characteristics and insurance coverage are significantly associated with visual prognosis in pediatric JIA-U.
- Targeted strategies addressing these disparities are crucial for improving visual outcomes in affected children.
Purpose:
Understanding sociodemographic factors associated with poor visual outcomes in children with juvenile idiopathic arthritis-associated uveitis may help inform practice patterns.
Patients And Methods:
Retrospective cohort study on patients <18 years old who were diagnosed with both juvenile idiopathic arthritis and uveitis based on International Classification of Diseases tenth edition codes in the Intelligent Research in Sight Registry through December 2020. Surgical history was extracted using current procedural terminology codes. The primary outcome was incidence of blindness (20/200 or worse) in at least one eye in association with sociodemographic factors. Secondary outcomes included cataract and glaucoma surgery following uveitis diagnosis. Hazard ratios were calculated using multivariable-adjusted Cox proportional hazards models.
Results:
Median age of juvenile idiopathic arthritis-associated uveitis diagnosis was 11 (Interquartile Range: 8 to 15). In the Cox models adjusting for sociodemographic and insurance factors, the hazard ratios of best corrected visual acuity 20/200 or worse were higher in males compared to females (HR 2.15; 95% CI: 1.45-3.18), in Black or African American patients compared to White patients (2.54; 1.44-4.48), and in Medicaid-insured patients compared to commercially-insured patients (2.23; 1.48-3.37).
Conclusion:
Sociodemographic factors and insurance coverage were associated with varying levels of risk for poor visual outcomes in children with juvenile idiopathic arthritis-associated uveitis.
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