Epidemiological characterization of uveitis in the elderly population: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to characterize etiological patterns of uveitis in individuals aged 60 years or older.

Following the PRISMA 2020 and MOOSE reporting guidelines, we searched PubMed/MEDLINE, Scopus, PubMed Central (PMC), and Web of Science (January 1, 2005-January 1, 2025). Data extraction focused on study characteristics, sample size, uveitis location, and reported causes. Random-effects models were used to pool proportions across studies, heterogeneity assessed by the I² statistic. Methodological quality was evaluated via the Newcastle-Ottawa Scale for cohort studies and the JBI Critical Appraisal Checklist for cross-sectional studies.

Out of 10,829 retrieved citations, 16 studies met the inclusion criteria. Idiopathic uveitis constituted the largest proportion, with a pooled proportion of 41.45% (95% CI 30.63-53.16%). Infectious etiologies included herpetic uveitis (pooled proportion 11.40%, 95% CI 7.45-17.04%), cytomegalovirus (3.09%, 95% CI 1.01-9.06%) and tuberculosis (5.10%, 95% CI 2.58-9.83%). Non-infectious causes, such as sarcoidosis (5.21%, 95% CI 2.78-9.55%) and HLA-B27-associated uveitis (6.05%, 95% CI 3.35-10.71%), also contributed substantially. High heterogeneity (I² > 75%) was noted across most etiologies, likely reflecting variable study populations, diagnostic criteria, and geographic factors.

Our meta-analysis underscores the diverse etiological landscape of uveitis in the elderly, with over 40% of cases remaining idiopathic. High heterogeneity highlights regional variations and diagnostic challenges. Standardized evaluation protocols and improved access to advanced investigations may help reduce the burden of undiagnosed cases. Within Asia, the only continent contributing multiple studies, subgroup analysis reduced heterogeneity for some etiologies, suggesting that regional factors contribute to the observed variability.