Reproductive Life Stages and Female Sex-Specific Patterns in Uveitis Activity: Data From the AIDA Network Uveitis...

Area of Science:

• Ophthalmology
• Immunology
• Reproductive Health

Background:

• Noninfectious uveitis (NIU) is a significant cause of vision loss.
• Understanding how NIU activity varies across different life stages and sexes is crucial for effective management.
• Reproductive life stages (RLS) may influence disease activity due to hormonal and physiological changes.

Purpose of the Study:

• To investigate the relationship between noninfectious uveitis (NIU) activity and reproductive life stages (RLS) in relation to sex.
• To identify specific RLS and sex interactions that modify NIU disease activity.
• To inform patient education, risk stratification, and therapeutic strategies for NIU.

Main Methods:

• An observational, retrospective, cross-sectional registry-based study.
• Included female patients with NIU and male patients as controls, enrolled in the AIDA Network Uveitis Registry (2020-2025).
• Assessed NIU activity using flare frequency, anterior chamber cells (ACC), anterior chamber flare, vitreous haze, new posterior segment inflammatory signs, and immunosuppressive treatment (IST) exposure across defined RLS.

Main Results:

• A total of 425 female and 275 male patients were analyzed.
• Relapse frequency varied significantly across RLS (P = .014), with a perimenopausal peak observed only in women.
• A statistically significant interaction between RLS and sex was found (P = .044).
• Pediatric cases (prepuberty and early puberty) showed higher rates of anterior chamber cells (ACC) and required more IST (P = .012).

Conclusions:

• Reproductive life stages (RLS) are significant modifiers of uveitis activity and sex-specific patterns.
• Early puberty and perimenopause are associated with increased NIU relapse risk.
• Pediatric NIU cases present with more severe anterior inflammation and necessitate more intensive immunosuppressive treatment (IST).